Readability and Comprehension of the Geriatric Depression Scale and PROMIS® Physical Function Items in Older African Americans and Latinos.

BACKGROUND: Depression and physical function are particularly important health domains for the elderly. The Geriatric Depression Scale (GDS) and the Patient-Reported Outcomes Measurement Information System (PROMIS®) physical function item bank are two surveys commonly used to measure these domains. It is unclear if these two instruments adequately measure these aspects of health in minority elderly. OBJECTIVE: The aim of this study was to estimate the readability of the GDS and PROMIS® physical function items and to assess their comprehensibility using a sample of African American and Latino elderly. METHODS: Readability was estimated using the Flesch-Kincaid and Flesch Reading Ease (FRE) formulae for English versions, and a Spanish adaptation of the FRE formula for the Spanish versions. Comprehension of the GDS and PROMIS® items by minority elderly was evaluated with 30 cognitive interviews. RESULTS: Readability estimates of a number of items in English and Spanish of the GDS and PROMIS® physical functioning items exceed the U.S. recommended 5th-grade threshold for vulnerable populations, or were rated as 'fairly difficult', 'difficult', or 'very difficult' to read. Cognitive interviews revealed that many participants felt that more than the two (yes/no) GDS response options were needed to answer the questions. Wording of several PROMIS® items was considered confusing, and interpreting responses was problematic because they were based on using physical aids. CONCLUSIONS: Problems with item wording and response options of the GDS and PROMIS® physical function items may reduce reliability and validity of measurement when used with minority elderly.

Case Study of an Unsustainable Community-Academic Partnership: Toward Core Standards for the Structure of Emerging Participatory Research.

This report retrospectively examines the structure of an emerging community-academic participatory research (PR) partnership that was not sustainable, despite attempts to adhere to PR principles and demonstrable success in research outcomes. The influence of community and academic parent organizations on the PR process and outcomes is presented in the context of the Donabedian Model. We dissected the structural elements contributed by parent organizations to forming the structure of the PR partnership (memorandum of understanding, policy environment, human resources and effort, community and academic resources, expertise and experience, and funding) and explored the influence of potential and actual conflicts on the PR partnership's sustainability. The effect of potential and actual conflict on the PR process and quality of PR outcomes is discussed. Based on this, we conclude by proposing seven core standards for the establishment and development of emerging community-academic PR partnerships.

Choice of the best equation for plasma osmolality calculation: Comparison of fourteen formulae.

BACKGROUND: Many different equations have been previously described to estimate plasma osmolality. The aim of this study is to compare 14 of these equations, in order to determine which results agree best with measured osmolality. OBJECTIVES: Our aim is to elucidate which is the most accurate equation for osmolality calculation among the fourteen that were previously described. METHODS: We measured osmolality by the freezing point depression method, and glucose, urea, sodium, potassium, calcium and magnesium concentrations with Unicell DXC 800 analyzer. Goodness-of-fit rates were calculated using the Passing-Bablok regression model and the t-paired sample test. In addition, we used survival curves in order to find the percentage of cases in which the difference between measured and calculated osmolality was under 10 mOsm/kg. Data were plotted using the Bland-Altman graphical approach. RESULTS: The equation that provides the best fit between measured and calculated osmolality is 1.86(Na+K)+1.15(Glu/18)+(Urea/6)+14, followed by 2Na+1.15(Glu/18)+(Urea/6). CONCLUSIONS: According to our results, the Dorwart-Chalmer's equation should not be used for osmolality calculations. The equation 1.86(Na+K)+1.15(Glu/18)+(Urea/6)+14 is the most accurate. The widespread use of the equation 2(Na+K)+(Glu/18)+(Urea/6) is also acceptable.

Performance characteristics of loci method for measuring cardiac troponin I on the dimension EXL.

OBJECTIVE: To define the performance characteristics of the LOCI® method for cardiac troponin I on the Dimension EXL system. DESIGNS AND METHODS: Three different levels of commercial control (mean concentrations 0.426, 1.42, and 18.64 µg/L) were used for the imprecision study, quantifying separately within-run and between-run over 20 days. The limit of blank (LoB) and limit of detection (LoD) were assessed with 20 replicates of a sample without troponin I. Linearity was assessed by regression analysis. In addition, we studied inaccuracy, carry-over and limit of quantitation and conducted a method comparison with the Stratus CS (n=69). The reference interval was determined in 146 healthy blood donors using non-parametric method. RESULTS: The within-run imprecision (coefficient of variation [CV], %) obtained at each level was 2.4, 1.4% and 2.2%, while the between-run imprecision (CV,%) was 3.3%, 2.9% and 2.5%. Total imprecision was 4.06%, 3.3% and 3.4% for each control level. The limit of quantitation which corresponds to the troponin I concentration at which CV=10% was 0.05 µg/L. Method comparison with the Stratus CS assay produced the equation: Dimension EXL=-0.002698+1.0233⁎(Stratus CS) with a confidence interval from -0.01562 to 0.00626 for the intercept and (0.979 to 1.0875) for the slope. The 99th percentile obtained for the reference population was 0.047 µg/L. CONCLUSIONS: The LOCI method for cardiac troponin I on the Dimension EXL meets all guidelines recommended criteria referring to limit of quantitation, imprecision and shows excellent transferability with the Stratus CS method.

Improving Diabetes Health Literacy by Animation.

PURPOSE AND SCOPE: To produce a Spanish/English animated video about diabetes; to qualitatively assess cultural and linguistic appropriateness; and to test effectiveness at improving diabetes health literacy among Latino/Hispanics. METHODS: Participatory research and animation production methods guided development of the video. Cultural appropriateness was assessed through focused discussion group methods. A prospective randomized controlled trial tested the effectiveness of the Spanish version at improving diabetes health literacy, compared to "easy to read" diabetes information from the National Institute of Diabetes and Digestive and Kidney Diseases. Functional health literacy was measured by the Short Test of Functional Health Literacy in Adults. Diabetes health literacy was measured by the Diabetes Health Literacy Survey (DHLS). RESULTS: No significant differences were recorded between experimental (n = 118) and control groups (n = 122) at baseline on demographic characteristics, Short Test of Functional Health Literacy in Adults score, or DHLS score. Fifty-eight percent of the study participants had inadequate functional health literacy. Mean DHLS score for all participants and those having adequate functional health literacy were 0.55 and 0.54, respectively (inadequate diabetes health literacy). When adjusting for baseline DHLS score, sex, age, and insurance status, DHLS scores improved significantly more in the experimental group than the control group (adjusted mean = 55% vs 53%, F = 4.7, df = 1, P = .03). Interaction between experimental group and health literacy level was significant (F = 6.37, df = 2, P = .002), but the experimental effect was significant only for participants with inadequate health literacy (P = .009). CONCLUSIONS: The positive effect on DHLS scores suggests that animation has great potential for improving diabetes health literacy among Latinos having limited functional health literacy. A study is needed that targets participants with inadequate health literacy and that uses the English and Spanish versions of the video.

Evaluation of marking efficiency of different alizarin red S concentrations on body fish structures in Oreochromis niloticus (Perciformes: Cichlidae) juveniles.

The use of alizarin red S (ARS) marked tilapias could provide valuable fisheries management information to evaluate fish stocking events and may facilitate aquaculture management practices. As a new technique in fishes, the aim of this study was to compare and evaluate the chemical marks produced in tilapia juveniles by ARS through two treatments: 1) 12 hours of immersion and 2) immersion after osmotic induction. This was analyzed at three concentrations: 50, 75 and 100mg/l, and in three structures: otoliths, fish scales and caudal fin rays of Oreochromis niloticus juveniles. After three culture months 80% of specimens were analyzed and significant differences (p<0.05) in mark intensity were detected between treatments for otoliths and fin rays, but not for fish scales. Significant differences between concentrations were found for the 12h immersion treatment, while no significant differences were detected with osmotic induction. Our results showed that marks appeared at all concentrations, and none of the concentrations produced weak marks. Osmotic induction had a greater mortality than the 12h immersion procedure. After eight culture months the rest of the specimens were analyzed and the mark permanence was observed in all cases. According to the present results we recommend the marking process of 12h immersion treatment at 100mg/L concentration.

Evaluation of marking efficiency of different alizarin red S concentrations on body fish structures in Oreochromis niloticus (Perciformes: Cichlidae) juveniles

The use of alizarin red S (ARS) marked tilapias could provide valuable fisheries management information to evaluate fish stocking events and may facilitate aquaculture management practices. As a new technique in fishes, the aim of this study was to compare and evaluate the chemical marks produced in tilapia juveniles by ARS through two treatments: 1) 12 hours of immersion and 2) immersion after osmotic induction. This was analyzed at three concentrations: 50, 75 and 100mg/l, and in three structures: otoliths, fish scales and caudal fin rays of Oreochromis niloticus juveniles. After three culture months 80% of specimens were analyzed and significant differences (p<0.05) in mark intensity were detected between treatments for otoliths and fin rays, but not for fish scales. Significant differences between concentrations were found for the 12h immersion treatment, while no significant differences were detected with osmotic induction. Our results showed that marks appeared at all concentrations, and none of the concentrations produced weak marks. Osmotic induction had a greater mortality than the 12h immersion procedure. After eight culture months the rest of the specimens were analyzed and the mark permanence was observed in all cases. According to the present results we recommend the marking process of 12h immersion treatment at 100mg/L concentration.

El uso de alizarina roja S (ARS) para marcar tilapias podría proporcionar información valiosa para el manejo de su pesquería. Para evaluar pesquerías acuaculturales manejadas con siembras o repoblamientos de peces se comparó y evaluó la marca producida por la alizarina roja S, empleando dos tratamientos: 1) Inmersión en ARS durante 12h; e 2) Inmersión en ARS después de un choque osmótico. El análisis se realizó a tres concentraciones: 50, 75 y 100mg/l y en tres estructuras: otolitos, escamas y radios de la aleta caudal de Oreochromis niloticus. Ochenta por ciento de los ejemplares fueron cultivados durante tres meses y analizados posteriormente. Los resultados mostraron diferencias entre las concentraciones de la marca para el tratamiento de 12h de inmersión mientras que no hubo diferencias entre las concentraciones para el tratamiento con inducción osmótica. Se encontraron diferencias en la intensidad de la marca entre los tratamientos para otolitos y radios de las aletas pero para las escamas no hubo diferencias significativas. Todas las concentraciones produjeron marcas (desde débiles a intensas), sin embargo la concentración de 100mg/l no produjo marcas débiles. El tratamiento por inducción osmótica presentó mayores niveles de mortalidad. Después de ocho meses de cultivo el resto de los ejemplares fueron analizados y se observó la permanencia de las marcas en todos los casos. En vista de lo anterior, para los propósitos de marcaje se recomienda el uso del tratamiento de inmersión por 12h y una concentración de 100mg/l.

Psychometric performance of the National Eye Institute visual function questionnaire in Latinos and non-Latinos.

OBJECTIVE: To compare the psychometric performance of Spanish versions of the 25-item National Eye Institute Visual Function Questionnaire (NEI VFQ-25) and the NEI VFQ-39 administered to Latino patients with the psychometric performance of the standard English NEI VFQ-25 and NEI VFQ-39 administered to non-Latino patients. DESIGN: Clinic-based cross-sectional survey. PARTICIPANTS: Four hundred three patients (160 Latinos and 243 non-Latinos) recruited from general ophthalmology clinics of an urban public hospital over a 6-month period. METHODS: Structured face-to-face interviews were conducted in Spanish and English to collect data for the NEI VFQ-25 and NEI VFQ-39. We calculated the mean, standard deviation, and percentage of participants having the minimum (floor) and maximum (ceiling) possible score for each item and scale. Internal consistency reliability of the NEI VFQ-25 and NEI VFQ-39 was estimated using the Cronbach alpha and average inter-item correlation. Construct validity for the instruments was assessed by comparing scores for participants classified as having normal versus impaired visual acuity. MAIN OUTCOME MEASURES: Instrument scales for general health; general vision; ocular pain; near activities; distance activities; vision-specific social functioning, mental health, role difficulties, and dependency; driving; color vision; and peripheral vision. RESULTS: Internal consistency reliability was significantly lower in the Spanish version than in the English version for 3 scales of the NEI VFQ-25. More importantly, 3 scales in the Spanish version manifested inadequate reliability (alpha< or =0.70), compared with only 1 inadequately reliable subscale in the English version. Reliability coefficients associated with the Spanish NEI VFQ-39 scales exceeded commonly accepted minimum standards. Comparison of reliability coefficients between Latino and non-Latino subgroups demonstrated statistically significant differences for 4 scales: Ocular Pain, Mental Health, Role Difficulties, and Dependency. In each case, the Latino group had the lower internal consistency reliability. However, only for the Ocular Pain subscale was reliability both significantly lower and inadequate (alpha<0.70). CONCLUSION: Overall performance of the NEI VFQ in Latino populations is adequate. However, in the absence of modifications to improve the reliability of specific Spanish version subscales, comparisons between Latino and non-Latino subgroups using the NEI VFQ must be interpreted with appropriate caution.

An ethno-medical perspective on research participation: a qualitative pilot study.

BACKGROUND: Recruitment of racial/ethnic minorities for clinical research continues to be problematic, yet critical to ensuring that research data will be applicable to diverse populations. There is a paucity of information about culturally appropriate methods for recruiting and retaining racial/ethnic minorities in research. OBJECTIVE: To cross-culturally assess perceptions of research participation by African American and immigrant Latinos living in the inner-city community of Watts, Los Angeles, California, using qualitative methods. DESIGN: Focus groups using ethnically matched moderators were convened with African American and immigrant Latino participants. Discussion was facilitated using a script that focused on perceived "feelings" and "perceptions" about research. Discussions were audiotaped, transcribed, and analyzed using manual and computerized statistically based software (mixed) methods. RESULTS: African Americans and immigrant Latinos shared several barriers and motivators to research. However, they also reported barriers and motivators to research that were distinct to each group. Latinos were more interested in healthcare and health information, and African Americans were more concerned with issues of trust and quality of care. Most participants said they would participate in research if they were better informed, or if they or a family member had an illness. Improving communication was reported as being important for motivating participation in clinical research. Overall, socioecologically and socioeconomically based domains were shared, whereas historically and/or socioculturally based domains were distinct. CONCLUSIONS: Using an ethno-medical science model, we demonstrated that it is possible to identify shared barriers and motivators to research participation between 2 distinct cultural groups. This approach can be useful in developing targeted community-based strategies to increase minority participation in clinical trials.

Variation in the readability of items within surveys.

The objective of this study was to estimate the variation in the readability of survey items within 2 widely used health-related quality-of-life surveys: the National Eye Institute Visual Functioning Questionnaire-25 (VFQ-25) and the Short Form Health Survey, version 2 (SF-36v2). Flesch-Kincaid and Flesch Reading Ease formulas were used to estimate readability. Individual survey item scores and descriptive statistics for each survey were calculated. Variation of individual item scores from the mean survey score was graphically depicted for each survey. The mean reading grade level and reading ease estimates for the VFQ-25 and SF-36v2 were 7.8 (fairly easy) and 6.4 (easy), respectively. Both surveys had notable variation in item readability; individual item readability scores ranged from 3.7 to 12.0 (very easy to difficult) for the VFQ-25 and 2.2 to 12.0 (very easy to difficult) for the SF-36v2. Because survey respondents may not comprehend items with readability scores that exceed their reading ability, estimating the readability of each survey item is an important component of evaluating survey readability. Standards for measuring the readability of surveys are needed.

Alternative healthcare use in the under-served population.

OBJECTIVE: To apply the Behavioral Model for Vulnerable Populations to the examination of the correlates of alternative healthcare utilization among Hispanic and African-American adults residing in public housing. DESIGN: Cross-sectional survey of a community-based sample. SETTING: Urban public housing communities in the county of Los Angeles. PARTICIPANTS: A geographically defined random sample of 287 African-American and Latino heads of households from three urban public housing communities. RESULTS: The use of alternative health care was assessed with three indices reflecting how frequently respondents used alternative sources of health care: 1) to prevent sickness; 2) to treat sickness; and 3) to substitute for conventional health care. Multivariate analysis of data indicates that lower education, greater perceived racial discrimination, and poorer health status were associated with the use of alternative health care to prevent sickness. Furthermore, greater perceived racial discrimination, greater financial strain, and poorer health status were associated with the use of alternative health care to treat sickness. In addition, four variables were associated with increased frequency of alternative healthcare utilization as a substitute for conventional care, namely: 1) diminished belief that powerful individuals (such as healthcare professionals) control one's health; 2) greater perception of racial discrimination; 3) greater financial strain; and 4) reduced access to health care. CONCLUSION: Enabling characteristics helped explain the use of alternative health care to treat sickness as a substitute for conventional health care, but not to prevent sickness, in this population. Perceived racial discrimination was the strongest correlate for each type of alternative healthcare use, while health status was also a strong predictor. The use of alternative health care for prevention and for substitution should be examined separately in disadvantaged minority populations.

A profile of chronic mental and physical conditions among African-American and Latino children in urban public housing.

OBJECTIVE: This study provides a profile of chronic mental and physical conditions among African-American and Latino children in urban public housing communities in Los Angeles, California. METHODS: The study focused on 187 African-American and Latino households with children, 65% of a random sample of 287 households in three urban public housing communities. RESULTS: The findings suggest that minority children residing in public housing are one of the more severely health-compromised groups among under-served communities. Children of Latino and African-American families in our sample are two to four times more likely to suffer from chronic physical and mental conditions than the general population. The top five childhood chronic conditions reported by parents for one or more children in their households were asthma (32%), eye/vision problems (24%), dental problems (16%), Attention Deficit Hyperactivity Disorder (17%), and depression (8%). CONCLUSION: This study documents significant health disparities in this population and strongly suggests the need for future investigations in similar settings nationwide.

Multi-cultural surveillance for ectopic pregnancy: California 1991-2000.

BACKGROUND: National surveillance for ectopic pregnancy (EP), the primary cause of maternal death in the first trimester, began in 1970. EP rates peeked during the late 1980s and have been highest for African Americans. However, limited reports on EP rates exist for other racial/ethnic groups. OBJECTIVES: To report state-level, multicultural trends in EP rates from 1991 to 2000. METHODS: Secondary data analysis of the California hospital discharge database collected by the Office of Statewide Health Planning and Development by using codes 633.0-633.9, from the International Classification of Diseases, Ninth Revision. EP rates are reported per 1000 pregnancies. RESULTS: From 1991 to 2000, 62,839 EP were reported in California. Mean EP rate was 11.2/1000, decreased from 15/1000 to 9.3/1000, and varied significantly by race/ethnicity and age. EP rates were highest among African Americans (25/1000) and lowest among Hispanics (7.7/1000); African Americans had higher odds of having EP relative to non-Hispanic Whites (odds ratio [OR] 2.14, 95% confidence interval [CI] 2.09-2.19). Women 35-44 years of age had the highest EP rates (17.6/1000) and higher odds of having EP compared to other age groups (OR 2.45, 95% CI 2.39-2.50). The highest rate of EP was found among African Americans 35-44 years of age (43.1/1000). CONCLUSIONS: The study showed declining EP rates in California for all groups but highlights disparities in EP rates and the attenuated rate of decline for African Americans, which places them at highest risk of death in the first trimester. This study demonstrates the usefulness of analyzing state-level data that may differ from aggregated national data when studying culturally diverse populations.

Improving Hawaiian and Filipino involvement in clinical research opportunities: qualitative findings from Hawai'i.

OBJECTIVE: Investigate the barriers to participation in medical research that involves Asian and Pacific Islander (API) populations in Hawai'i. PARTICIPANTS: Fifty people (27 Filipinos, 23 Hawaiian/Pacific Islanders) in five different communities on Oahu. DESIGN: Nine focus groups with an ethnically matched moderator were held to explore people's feelings, problems, and recommendations regarding medical research. Sessions were audiotaped, transcribed, and qualitatively analyzed with the constant comparison method. RESULTS: Only 12% of study participants said that they absolutely would not participate in a clinical study. Most agreed that research is vital. Filipino participants were more optimistic about the safety and value of joining in medical research. Hawaiian groups were more hesitant and fearful. Reasons for nonparticipation included negative feelings about the purpose and intent of clinical trials and language and cultural barriers. Suggestions on how to encourage API populations to participate in research investigations included improving peoples' understanding of the benefits to family and community. Hawaiian and Filipino groups differed only slightly in their assessments of the type of research needed in their communities. CONCLUSIONS: Recruitment campaigns must improve people's awareness of the process of informed consent, research safeguards, and benefits to family and community. Attention should focus on K-12 health education to use members of the younger generations to access and educate elders, involving persons with medical research experience as a recruitment resource, returning results to study participants, and increasing the number of healthcare professionals and researchers that are culturally and linguistically matched to the community.

Access to vision care in an urban low-income multiethnic population.

OBJECTIVE: This study applied a well-known, recently revised theoretical model of healthcare access and utilization, the Behavioral Model for Vulnerable Populations, to examine the relationship between access to care and utilization of eye care services among a multiethnic, predominately minority sample of residents from low-income public housing. DESIGN: Population-based, cross-sectional survey of community sample. SETTING: Urban Public Housing Communities in Los Angeles County, California. PARTICIPANTS: A geographically defined stratified random sample of 152 residents (86% Latino or African American) 40 years of age and older from three urban public housing communities. RESULTS: Only 62% of our sample of persons 40 years and older had received an eye examination within the past 2 years. Sixty-one percent of participants reported having vision care coverage. Yet, one out of four respondents claimed that no health care provider had ever told them that they needed an eye-examination. Applying multiple logistic regression and controlling for a number of predisposing, enabling, and need-for-care characteristics, the variables 1) receiving advice from health care providers for eye examination (OR = 3.9, p < 0.01), 2) possessing coverage for eye-care (OR = 3.2, p < 0.01), and 3) having regular and continuity of medical care (OR = 2.4, p < 0.01) remained significant predictors of eye-examination within the past 2 years. CONCLUSION: This study documents significantly diminished utilization of eye care services relative to recommended guidelines for a low-income, predominately minority sample of residents from public housing communities. We documented no association between presence of diabetes or hypertension and recency of eye examination. Affordability, continuity, and regular sources of care, as well as receiving physician advice, remain the core factors significantly associated with receiving vision care. These results underscore the need for continued efforts to ensure that the medically underserved minority have access to vision care services. These findings also point toward the urgent need for educational and motivational interventions that encourage health care providers serving underserved communities to promote eye examination, particularly among diabetic patients, hypertensive patients, and other individuals at risk for eye-related disease and complications.

Pitfalls in health communication: healthcare policy, institution, structure, and process.

The state of health communication for a given population is a function of several tiers of structure and process: government policy, healthcare directives, healthcare structure and process, and the ethnosocial realities of a multicultural society. Common yet specific to these tiers of health communication is the interpersonal and intergroup use of language in all its forms. Language is the most common behavior exhibited by humankind. Its use at all tiers determines quality of healthcare and quality of life for healthcare consumers: patients and their families. Of note, at the consumer end, mounting evidence demonstrates that barriers to health communication contribute to poorer access to care, quality of care, and health outcomes. The lack of comprehensible and usable written and spoken language is a major barrier to health communication targeting primary and secondary disease prevention and is a major contributor to the misuse of healthcare, patient noncompliance, rising healthcare costs. In this paper, we cursorily examine the relationship among government policy, institutional directives, and healthcare structure and process and its influence on the public health, especially vulnerable populations. We conclude that limited health communication in the context of changing healthcare environments and diverse populations is an important underpinning of rising healthcare costs and sustained health disparities. More research is needed to improve communication about health at all tiers and to develop health communication interventions that are usable by all population groups.

Atributos del médico tratante: estudio desde el punto de vista del paciente / Physician attributes: a study on patient point of view

Los atributos del médico en su práctica profesional han sido definidos como virtudes de alto valor moral y ético. Sin embargo, éstas representan la perspectiva de los propios médicos respecto a sus pares. Mediante un estudio de encuesta a 104 pacientes adultos con patología quirúrgica no cancerosa, en etapa de diagnóstico se objetivó características deseables en el médico tratante desde el punto de vista del paciente, en relación a ciertas características personales y comunicacionales. El 56 por ciento de la muestra manifestó su opción por médicos con un rango etario definido y de ellos, el 90 por ciento lo prefiere entre 35 y 50 años. Más del 95 por ciento atribuye gran importancia a la seguridad del médico en sí mismo y a la capacidad de escuchar atentamente al paciente y de explicar detalladamente a éste su enfermedad y posibles tratamientos. El 83 por ciento le asignó gran importancia a la presentación personal y de ellos, el 56 por ciento prioriza el aseo personal por sobre el tipo de vestuario o el uso de delantal blanco. Menor importancia se atribuye a la simpatía y la puntualidad. Los pacientes prefieren la seguridad en sí mismo y la capacidad de comunicación como las variables más importantes en su relación con el médico

Prevalencia de gérmenes causantes de faringoamigdalitis en niños. Sensibilidad y respuesta terapéutica a la ampicilina- / Prevalence of germs causing pharyngotonsillitis in children. Sensiativity and therapeutic response to ampicillin

Este estudio fue realizado para analizar la prevalencia de gérmenes aislados en pacientes pediátricos con faringoamigdalitis bacteriana en la consulta privada a nivel de la comunidad, y al mismo tiempo evaluar la respuesta clínica al tratamiento con ampicilina. Material y métodos. Se incluyó a 516 pacientes de 12 ciudades de México, con diagnóstico de faringoamigdalitis bacteriana. Se practicaron exudados faríngeos antes y después del tratamiento con ampicilina y se probó la susceptibilidad in vitro a varios antibióticos (incluida la ampicilina). Resultados. El patógeno más aislado fue el estreptococo betahemolítico del grupo A de Lancefield (S. pyogenes), con 26.6 por ciento de prevalencia. En dichos cultivos la sensibilidad in vitro a ampicilina fue de 100 por ciento para el estreptococo grupo A betahemolítico. La respuesta global a ampicilina fue satisfactoria en 95 por ciento de los pacientes. Conclusiones. Los resultados de este estudio confirman datos anteriormente reportados en población pediátrica a nivel de la comunidad en México y otros países en vías de desarrollo; contrastan con los obtenidos en países del primer mundo y confirman la utilidad del tratamiento de las faringoamigdalitis bacterianas con ampicilina en países en vías de desarrollo.