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Biomedical subjects

X Berrios

Publications and source records attributed to X Berrios.

14 recordsLinked to original sources
PubMed2001

Community-based noncommunicable disease interventions: lessons from developed countries for developing ones.

Community-based programmes for prevention and control of cardiovascular diseases (CVD) started in Europe and the USA in the early 1970s. High mortality from CVD in Finland led to the start of the North Karelia Project. Since then, a vast amount of scientific literature has accumulated to present results and discuss experience. The results indicate that heart health programmes have a high degree of generalizability, are cost-effective and can influence health policy. In the 1980s the focus of programmes expanded from CVD to noncommunicable diseases (NCD), mainly because of the common risk factors. Attention has now turned to promoting this approach in developing countries, where the prevalence of NCD is growing. Theory and experience show that community-based NCD programmes should be planned, run and evaluated according to clear principles and rules, collaborate with all sectors of the community, and maintain close contact with the national authorities. In view of the burden of disease they represent and of globalization, there is a great need for international collaboration. Practical networks with common guidelines but adaptable to local cultures in a flexible way have proved to be very useful.

Cardiovascular Diseases↗
PubMed2001

Prevalence and mechanisms of macrolide resistance in Streptococcus pyogenes in Santiago, Chile.

Thirty-two macrolide-resistant Streptococcus pyogenes isolates were found among 594 clinical isolates collected from 1990 to 1998 in Santiago, Chile, for an overall prevalence of 7.2%. Among the 32 resistant isolates, 28 (87.5%) presented the M phenotype and 4 (12. 5%) presented the MLS(B) phenotype. Serotyping and pulsed-field gel electrophoresis analysis showed genetic diversity among the resistant isolates.

Anti-Bacterial Agents↗
PubMed1997

Distribution and prevalence of major risk factors of noncommunicable diseases in selected countries: the WHO Inter-Health Programme.

The Inter-Health Programme was launched in 1986 by WHO, with the collaboration of a coordination centre (National Public Health Institute, Finland) to control and prevent chronic noncommunicable diseases (CNCDs) among adults. Programmes for action were organized based on the concept that most major CNCDs share common risk factors and that those that are lifestyle related are modifiable through efficient interventions using multifactorial strategies involving community participation and behaviour changes carried out at the primary health care level. Twelve countries from all WHO Regions have joined the programme. A baseline survey was undertaken in all countries with a common protocol, following the criteria and methods employed in the MONICA Project. Altogether 36815 men and women aged 35-64 years were included in the present analysis from the following Inter-Health countries: Chile, China, Cyprus, Finland, Lithuanian SSR, Malta, Mauritius, Russian SFSR, United Republic of Tanzania, and USA. In addition to individual country analysis, centralized analysis was carried out at the Finnish National Public Health Institute and the Department of Community Health, Kuopio University, Finland. Reported here are the mean values of blood pressure, body mass index, and serum total cholesterol as well as specific prevalences of smoking, hypertension, obesity, and hypercholesterolaemia.

Adult↗
PubMed1993

Discontinuing rheumatic fever prophylaxis in selected adolescents and young adults. A prospective study.

OBJECTIVE: To assess the safety of discontinuing prophylaxis with antimicrobial agents in patients judged to be at relatively low risk for recurrence of acute rheumatic fever. DESIGN: Observational cohort study. SETTING: Public health clinics in the Southeast Health District of Santiago, Chile. PATIENTS: Fifty-nine patients (19 men, 40 women) ranging in age at study entry from 15 to 44 years (mean, 24.5 years). Forty-eight had completed their prescribed period of prophylaxis. Eleven refused or were allergic to intramuscular benzathine penicillin G and were non-compliant with oral sulfadiazine. INTERVENTION: In patients who did not have carditis during their previous attack(s), prophylaxis was discontinued after 5 years or at age 18, whichever was longer. In those with only mild mitral regurgitation or healed carditis, prophylaxis was stopped after 10 years or at age 25. Symptomatic intercurrent streptococcal throat infections were treated with antibiotics. MEASUREMENTS: Patients were seen every 3 months during the study (July 1982 to September 1988). For the first 4.25 years, throat cultures as well as sera samples for antistreptolysin O and anti-DNAse B assays were obtained at each visit. RESULTS: During laboratory surveillance, significant increases in antibody titers were detected in 56 instances (28.1 [95% CI, 21.7 to 36.5] per 100 patient-years), and 29 isolations of group A streptococci occurred (14.5 [CI, 10.1 to 20.8] per 100 patient-years). The patients were followed for a total of 3349 patient-months, during which time two acute rheumatic fever recurrences were observed (0.7 [CI, 0.2 to 2.6] per 100 patient-years). No recurrences occurred during an outbreak of acute rheumatic fever in 52 patients in the study area in 1986. CONCLUSIONS: These and other data indicate that acute rheumatic fever prophylaxis can safely be discontinued in young adults judged to be at low risk for recurrence and who are maintained under careful prospective surveillance.

Adolescent↗
PubMed1991

[Alcohol consumption in the adult population from the metropolitan region: prevalence and consumption modalities].

A representative sample from the adult population of metropolitan Santiago was surveyed for prevalence and modality of alcohol consumption. The "problem drinker" was identified according to the CAGE questionnaire. Socioeconomic situation was classified according to the method of Graffar. 70% of male and 50% of female drinkers consumed less than 400 ml of ethanol per month. Prevalence of drinking in males and females was: all categories 56.2 and 19.8%, regular drinkers 40.8 and 14.4%; heavy drinkers 4 and 0.82% and problem drinkers 12.4 and 1.5%, respectively. 85% were weekend drinkers, 11% consumed alcohol throughout the week. Males consumed mostly wine and mixed alcoholic beverages, females mostly the latter. In males, drinking was related to age and not to socioeconomic condition, except for problem drinkers who were mostly found in the low category. Females problem drinkers were found mostly in the high socioeconomic group. These data may be used in planing intervention strategies to prevent damage caused by alcohol consumption.

Adolescent↗
PubMed1990

[Risk factors for arterial hypertension in the natives of Easter Island].

Blood pressure, weight, height and cardiovascular risk factors were evaluated in 73 adults of Easter Island (mean age 49 +/- 12.9 (SD) years) in January 1989 and 1990. Their mean blood pressure (BP) was 129 +/- 24/81 +/- 14, significantly higher by 7/5 mm Hg than in 1979 (p < 0.05). Of the population studied 30% of subjects were hypertensives. Both systolic (S) and diastolic blood pressure (DBP) correlated with age (r = 0.40, p < 0.005 and r = 24, p < 0.05 respectively). In males body mass index correlated strongly with SBP and DBP (r = 0.55, p < 0.005 and r = 0.52, p < 0.01). Forty eight % of subjects were obese, 60% smoked (14 cigarettes/day), 38% drank alcohol and 70% lead sedentary lives; their level of stress was considered average. In 23 normotensives or undiagnosed hypertensives 24 hour urine was collected for sodium, potassium, creatinine and kallikrein; mean urinary sodium excretion was 121 +/- 39 mmol/day; potassium excretion 59 +/- 29 mmol/day, creatinine excretion 1383 +/- 489 mg/day and kallikrein excretion 682 +/- 355 mU/day; of these, only urinary sodium was significantly lower than values determined in a group of 29 continental volunteers. Eleven natives that had never left the island had similar BP and risk factors than a sex and age paired sample, who has spent 10.9 +/- 7.8 years in the continent. The present study demonstrates that Easter Island natives have increased their mean BP in 10 years, elevated their BP with age and have lost the protection previously associated to staying in the island.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1990

[Prevalence of risk factors for chronic diseases. A study in the general population of the metropolitan area, 1986-1987].

Risk factors for chronic diseases were studied in a random sample of 475 males and 728 females from the Metropolitan area of Santiago. A questionnaire was used to estimate the consumption of alcohol and tobacco and the level of physical activity. Weight and height were measured and socio-economic situation was classified according to Graffar. Prevalence rates for males and females were: hypertension 8.6 and 9.1%; obesity 13.2 and 22.7%; present sokers 50.7 and 43.4%; sedentarism 75.6 and 86.9%; alcohol consumption 56.2 and 19.8%. Thus, women show higher rates than males for hypertension, obesity and sedentarism. They smoked as much as males and consumed less alcohol. Among women a higher prevalence of obesity, alcohol consumption and sedentarism was observed in lower socio-economic classes. Among males, only sedentarism was more prevalent in lower socio-economic classes. The number of risk factors present was 1 in 28.6% of the population; 2 in 40.1%; 3 in 22.1%; 4 in 3.7% and 5 in 0.1%. Absence of risk factors was observed in only 5.4% of the population. The present data may help to design preventive strategies for diseases related to these risk factors.

Adolescent↗
PubMed1989

Pharmacokinetics of benzathine penicillin G: serum levels during the 28 days after intramuscular injection of 1,200,000 units.

Because of published data suggesting the inadequacy of once-every-4-weeks intramuscular injections of benzathine penicillin G for secondary rheumatic fever prevention, serum penicillin levels were determined at 1, 3, 10, 21, and 28 days after administration of 1,200,000 units of this repository penicillin. A total of 193 samples were studied. Mean serum penicillin levels remained greater than or equal to 0.02 micrograms/ml for 21 days, but by 28 days only 44% of the serum samples had detectable levels of penicillin and only 36% had levels greater than or equal to 0.02 micrograms/ml. Patients weighing more than 45 kg had significantly lower serum penicillin levels than did those who weighed less. There were similar correlations with body surface area and with age. These data indicate that a significant percentage of patients receiving benzathine penicillin G prophylaxis for prevention of recurrent attacks of rheumatic fever are not protected during the fourth week. More frequent administration of benzathine penicillin G should be considered in instances of high risk of recurrence of rheumatic fever.

Adolescent↗
PubMed1986

Detection of C-reactive protein, streptolysin O, and anti-streptolysin O antibodies in immune complexes isolated from the sera of patients with acute rheumatic fever.

Circulating immune complexes (IC) of 42 patients with acute rheumatic fever from Santiago, Chile, were studied. The complexes were isolated by polyethylene glycol precipitation and were analyzed for antibodies, antigens, and C-reactive protein. We found the complexes to be enriched in antibody to streptolysin O, particularly in the group of patients with elevated levels of IC. IgM was the predominant class of Ig present in the complexes. Western blots from 12 patients to detect antigens in the complexes showed proteins of m.w. 50,000, 60,000, and 69,000, consistent with the polypeptides of streptolysin O. Such antigens were absent in the complexes from patients with post-streptococcal glomerulonephritis and pharyngitis. Eluted antibodies from these protein bands on the nitrocellulose sheets reacted with the streptolysin O in Western blots and neutralized the hemolytic activity of streptolysin O in a microhemolysin assay. In addition, isolated complexes from several sera showed the presence of C-reactive protein bound to complexes. In vitro experiments demonstrated that [125I]C-reactive protein was not precipitated by polyethylene glycol either alone or when added to monomeric IgG, whereas it precipitated significantly when added to aggregated IgG. The detectable C-reactive protein in isolated complexes and sera samples increased after treatment with sodium dodecyl sulfate. These data suggest that circulating immune complexes in acute rheumatic fever contain streptolysin O and its antibody and raise interesting questions regarding the pathogenetic significance of C-reactive protein in the complexes.

Antigen-Antibody Complex↗
PubMed1986

Acute rheumatic fever and poststreptococcal glomerulonephritis in an open population: comparative studies of epidemiology and bacteriology.

We conducted epidemiologic and bacteriologic studies of 104 cases of acute rheumatic fever (ARF) and 84 cases of poststreptococcal acute glomerulonephritis (AGN) occurring in the southeast health district of Santiago, Chile, between March 1978, and February 1982. The AGN cases were both postpharyngeal and postpyodermal in origin. Despite the fact that ARF and AGN were occurring in the same neighborhoods and among families of equivalent size and socioeconomic status, the pharyngeal isolation rates of group A streptococci were significantly lower among patients with ARF and their household contacts than among patients with AGN and their contacts. Moreover, the streptococcal throat colonization rates and geometric mean anti-streptolysin O titers were similar in ARF families and the families of noninfected controls. Streptococci of M-type 5, a highly rheumatogenic type, were isolated from three patients with ARF (representing 36% of group A isolates from this group) and one ARF contact but never from patients with AGN, control subjects, or their respective contacts. These observations suggest possible differences in the streptococcal milieus from which ARF and AGN cases emerge. The nature of such differences requires further exploration.

Adolescent↗
PubMed1985

Are all recurrences of "pure" Sydenham chorea true recurrences of acute rheumatic fever?

We are conducting prospective studies of patients in Santiago, Chile, who have had an attack of rheumatic fever and are receiving continuous secondary prophylaxis with monthly injections of benzathine penicillin G. Throat cultures are obtained just prior to injection each month, and serum antistreptococcal antibody titers (antistreptolysin O and antideoxyribonuclease B) are performed at least every 3 months. During the course of these studies we have observed 17 recurrences of "pure" chorea in 10 patients (six girls). In four recurrences the timing of serologic studies and onset of chorea appeared to exclude the occurrence of an immunologically significant group A streptococcal infection within the preceding 6 to 9 months. In one case the period of serologic follow-up was too brief to allow a definite determination. In the remaining 12 recurrences serologic evidence was suggestive or confirmatory of recent streptococcal infection; however, in several instances the titer elevations were quite modest. Our data suggest that in certain chorea-prone patients, Sydenham chorea may recur after streptococcal infections too weak and transient to be readily detectable or, alternatively, after stimuli other than streptococcal infection.

Adolescent↗
PubMed1982

Type-specific antibodies to structurally defined fragments of streptococcal M proteins in patients with acute rheumatic fever.

Group A streptococci of M protein type 5 have been epidemiologically related to acute rheumatic fever in a number of reported outbreaks. Preliminary bacteriological evidence suggests that M5 may be an important "rheumatogenic" type in Santiago, Chile. To assess further the relationship of this streptococcal serotype to rheumatic fever in Chile, sera of 34 patients with rheumatic fever and an equal number of age-, sex-, and race-matched controls were assayed for antibodies to types 5, 6, and 24 in an enzyme-linked immunosorbent assay with purified pepsin extracts of the respective M proteins as solid-phase antigens. Sera of 11 rheumatic fever patients (32%) were positive (titer greater than 1:800) for type 5 antibodies, but only 1 (3%) of the matched controls was positive (P less than 0.01). Neither the patients nor the controls had antibodies to type 24. Although 38% of the patient sera contained antibodies to type 6, 29% of the control sera also had such antibodies (P greater than 0.20). The enzyme-linked immunosorbent assay served as an accurate predictor of which sera contained type 5 opsonic antibodies as measured by the opsonophagocytic test. Although antigenic cross-reactivity exists between M protein type 5 and type 6 group A streptococci, this phenomenon is unlikely to have accounted for the preferential occurrence of type 5 antibodies in rheumatic fever sera. The enzyme-linked immunosorbent assay and opsonic antibody results suggest that M5 is an important rheumatogenic type in Chile.

Antibodies, Bacterial↗