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At least 1,225 records · Page 68Linked to original sources
PubMed1978

A hypothesis on the declining dizygotic twinning rates in developed countries.

1) There has been an unexplained drop in dizygotic twinning rates during the past 15--20 years in all the developed countries for which data are available. In this note an explanation is offered for this decline. 2) There has been a decline in birth rates in almost all developed countries over much of the same period. 3) There is good evidence that in recent years there has been a decline in sperm counts--at any rate in the United States. 4) It is suggested here that this decline in sperm counts has been responsible for a decline in the probability that coitus in the fertile period will result in fertilization of the ovum. It is hypothesized that this decline is responsible for the decline in dizygotic twinning rates and--partially--for the decline in birth rates.

Birth Rate↗
PubMed1991

Considerations for conducting epidemiologic case-control studies of cancer in developing countries.

The challenges involved in conducting epidemiologic studies of cancer in developing countries can be and often are unique. This article reports on our experience in performing a case-control study of invasive cervical cancer in four Latin American countries (Columbia, Costa Rica, Mexico, and Panama), the summary medical results of which have been published in a previous issue of this journal (1). The study involved a number of principal activities--mainly selecting, conducting interviews with, and obtaining appropriate biologic specimens from 759 cervical cancer patients, 1,467 matched female controls, and 689 male sex partners of monogamous female subjects. This presentation provides an overview of the planning and methods used to select the subjects, conduct the survey work, and obtain complete and effectively unbiased data. It also points out some of the important advantages and disadvantages of working in developing areas similar to those serving as locales for this study.

Case-Control Studies↗
PubMed1993

[Health education in developing countries--Indian health promoters in a tuberculosis prevention program in the Chaco region of Paraguay].

Several characteristics obstacles exist in developing countries in respect of implementation or realisation of health programmes. The following article, however, shows how effective preventive health and health care measures can be made possible even in the face of seemingly insurmountable difficulties. The only presently existing model basing on many years of experience, consequent development and documented success in the targeted prophylaxis of tuberculosis, is that of the Latin American Indian health promoters in the Chaco of Paraguay. The article discusses the results of the authors' own investigations regarding the training curriculum for the job of a "health promoter", delegation and distribution of tasks and success of the programme (incidence of tuberculosis and death rates). These are discussed in respect of general consequences for a concept of health training in developing countries.

Cause of Death↗
PubMed2002

Impact of topical oils on the skin barrier: possible implications for neonatal health in developing countries.

UNLABELLED: Topical therapy to enhance skin barrier function may be a simple, low-cost, effective strategy to improve outcome of preterm infants with a developmentally compromised epidermal barrier, as lipid constituents of topical products may act as a mechanical barrier and augment synthesis of barrier lipids. Natural oils are applied topically as part of a traditional oil massage to neonates in many developing countries. We sought to identify inexpensive, safe, vegetable oils available in developing countries that improved epidermal barrier function. The impact of oils on mouse epidermal barrier function (rate of transepidermal water loss over time following acute barrier disruption by tape-stripping) and ultrastructure was determined. A single application of sunflower seed oil significantly accelerated skin barrier recovery within 1 h; the effect was sustained 5 h after application. In contrast, the other vegetable oils tested (mustard, olive and soybean oils) all significantly delayed recovery of barrier function compared with control- or Aquaphor-treated skin. Twice-daily applications of mustard oil for 7 d resulted in sustained delay of barrier recovery. Moreover, adverse ultrastructural changes were seen under transmission electron microscopy in keratin intermediate filament, mitochondrial, nuclear, and nuclear envelope structure following a single application of mustard oil. CONCLUSION: Our data suggest that topical application of linoleate-enriched oil such as sunflower seed oil might enhance skin barrier function and improve outcome in neonates with compromised barrier function. Mustard oil, used routinely in newborn care throughout South Asia, has toxic effects on the epidermal barrier that warrant further investigation.

Administration, Topical↗
PubMed1988

Oral rehydration in infants in developing countries.

Diarrhoeal diseases are the major cause of infant mortality in developing countries. Dehydration is the most common complication of diarrhoea, and severe dehydration causes up to 80% of diarrhoeal fatalities. For more than 100 years, physicians focused the treatment of diarrhoeal diseases on the symptom diarrhoea, and there were many 'antidiarrhoeal' drugs, such as water adsorbents (kaolin and pectin) and antiperistaltics (opium, paregoric elixir, diphenoxylate hydrochloride with atropine sulphate and loperamide). This approach focused on a non-dangerous symptom and diverted attention from the real killer, dehydration. A few decades ago, only severely dehydrated patients were treated by intravenous therapy. This treatment was prescribed by a group of professional health workers, administered intravenously by skilled nurses, and reserved for the few patients resident near health facilities. Oral rehydration therapy (ORT), developed 20 years ago, has several advantages over intravenous therapy; it can be administered at home, at health clinics or in modern hospitals, by parents or by nurses or physicians. Most serum disturbances in dehydrated neonates, infants, children, adults and the elderly are resolved by this treatment.

Developing Countries↗
PubMedDate not supplied

Nutritional effects on response of children in developing countries to respiratory tract pathogens: implications for vaccine development.

Malnutrition and respiratory disease commonly occur together, and the immunologic defects caused by malnutrition may affect clinical responses and the impact of vaccines. These defects include impaired maturation and function of T lymphocytes, diminished secretory immune responses, poor humoral antibody responses to polysaccharide antigens, deficient complement activity (especially the alternative pathway), and impaired antimicrobial mechanisms by phagocytic cells. In addition, protein-energy malnutrition often leads to very high serum levels of IgE as a result of altered T cell regulation of IgE production and may contribute to IgE-mediated pathologic responses to respiratory syncytial virus or parainfluenza virus infection. Correction of these deficits may improve host response to infection and enhance vaccine-related protection. Both vitamin A and iron deficiency states have been epidemiologically associated with increased morbidity due to respiratory infection. The impact of preventive therapy with either vitamin A or iron is still uncertain, but such therapy has the potential for diminishing the incidence of respiratory infections and their consequences.

Child↗
PubMed1979

Training of doctors and delivery of health care in developing countries.

In the past two decades, the training of doctors in developing countries has become confused with the delivery of health care. There should be a balance in the financial aid directed to rural and to urban areas; at present rural areas receive too much. The urban hospital, and especially the national teaching hospital, where most of the teaching, care of the seriously sick, and research are done, is in decline. In the training of doctors, the vital clinical approach, oriented towards the individual patient, is losing ground.

Curriculum↗
PubMed1981

Primary closure of excisional defects of the breast with local flaps: a problem in the treatment of advanced carcinoma of the breast in developing countries.

Large, advanced, fungating breast tumours are a special problem in developing countries. The surgical treatment is often confined to rescue and relief and primary closure of the excisional defect is highly desirable. Split-skin grafts are often unsatisfactory for many reasons. Full thickness local flaps, cut as thickly as possible, give the best results and the "sheet anchor" in skin cover is the medially based deltopectoral flap. Myocutaneous flaps can be useful in treating low inner quadrant growths and lesions which leave no room for a deltopectoral flap.

Breast Neoplasms↗
PubMed1995

An environmental classification of housing-related diseases in developing countries.

A preliminary environmental classification of housing-related diseases in developing countries is presented. This groups these diseases into six categories: those related to defects in (1) buildings and the peridomestic environment, (2) water supply, (3) sanitation, (4) refuse storage and collection and (5) food storage and preparation; and (6) industry-related diseases resulting from housing location (close to polluting industries or on contaminated land) and from the use of the home as a workplace. Each category has three subcategories: communicable diseases (including zoonoses), non-communicable diseases, and mental illnesses and psychosocial disorders.

Developing Countries↗
PubMed1993

Injury surveillance: should it be a concern to developing countries?

Injuries have now become a recognizable public health problem in developing countries. However, no definite policies regarding their surveillance and control are yet available in most of these countries. This paper, using Ghana as a prototype, examines the need for policy and action which has been accentuated in recent times by public outcry. The paper also provides some recommendations to solve this problem: the urgent need to initiate programs such as needs assessment, the establishment of a surveillance system for injuries at various levels of health services, creation of public awareness and provision of health education, and the institution of simple first-aid measures. Specific policies regarding injuries from motor vehicle accidents and fires are also given.

Developing Countries↗
PubMed1980

Mental disorders in primary health care: a study of their frequency and diagnosis in four developing countries.

1624 patients who were attending primary health facilities in 4 developing countries were examined to determine how many were suffering from mental disorder. Using stringent criteria to establish the presence of psychiatric morbidity, 225 cases were found, indicating an overall frequency of 13.9%. The great majority of cases were suffering from neurotic illnesses and for most the presenting complaint was of a physical symptom, such as headache, abdominal pain, cough or weakness. The health workers following their normal procedure correctly detected one third of the psychiatric cases.

Adult↗
PubMed1978

The ascertainment of psychiatric cases in a developing country.

This artricle suggests procedures for locating these individuals in a developing country who have mental health problems. It assumes minimum facilities, e.g. that there is no mental hospital and no qualified psychiatrist and is based on experience in Tonga. The register of those involuntarily admitted to an institution looking after the mentally sick is invaluable for a variety of reasons and will well repay detailed study. Voluntary health and Welfare organisations may also supply valuable data. Home visiting often achieves much more than prearranged hospital or clinic appointments which are often not kept. A study of neglected cases may indicate the need to educate a community to recognize the value of medical treatment for the mentally sick.

Developing Countries↗
PubMed1978

[Results of simplified immunization schedules in the developing countries].

The results of studies on the immunization of people in developing countries with vaccines adsorbed on calcium phosphate are presented in this paper. Several programs which were studied with various organizations cooperating and which were intended to simplify vaccination campaigns brought us to the following conclusions: --that immunization against diphtheria and tetanus by two injections with an interval of one year between them is effective, --that two injections of inactivated trivalent poliomyelitis vaccine followed up by booster one year later ensure that 90% of the infants are protected, --that it is possible to vaccinate pregnant women by one or two injections of tetanus vaccine and protect both mothers and newborn babies against tetanus, and --that combined vaccines which enable simultaneous immunization of subjects against a maximum of infections are possible.

Developing Countries↗
PubMed1999

Determinants of contraceptive discontinuation in six developing countries.

This analysis investigates the determinants of contraceptive discontinuation in six developing countries, using data from Phase I surveys of the DHS programme. Cumulative probabilities of discontinuation at 24 months for reasons other than the desire for another child were examined. By this time, typically about 40% of couples have stopped use and most are subsequently at risk of an unwanted conception. Discontinuation of IUD use was found to be less common than for other methods, partly perhaps because cessation of use requires a deliberate decision to have the device removed. The most important results are negative ones. Neither the schooling of couples nor their type of residence exerted appreciable influence on discontinuation. The policy and programme implications are discussed. Prior use of a method, fertility preferences and the related demographic factors of age and family size emerged as pervasive predictors of discontinuation.

Adolescent↗
PubMed2000

Sarcoidosis in developing countries.

Sarcoidosis is seen in different parts of India and other developing countries with almost similar frequency as in the West. It was largely due to lack of awareness and non-availability of investigations for diagnosis that the disease was reported to be rare in the past. A combination of clinical, radiologic, and histologic criteria are used to diagnose sarcoidosis. A confident exclusion of other causes of granuloma formation, especially tuberculosis, is required. Absence of mycobacteria and of caseation in the histologic specimens and presence of skin anergy to tuberculin help make a diagnosis. Transbronchial lung biopsy obtained with the help of fiberoptic bronchoscopy is positive in about 80% of patients. Corticosteroids are used to treat patients with symptoms and those showing active organ involvement. Aggressive treatment is required for patients with acute and severe pulmonary, cardiac, ocular, or neurologic involvements.

Adult↗
PubMed2000

Corpus callosotomy in Colombia and some reflections on care and research among the poor in developing countries.

The authors present the results of a series of corpus callosotomies (CCS) in 97 patients performed from 1989 to 1997 at the Hospital Neurologico of the Liga Colombiana Contra La Epilepsia, Cartagena, Colombia. This study demonstrates the feasibility of performing these procedures in the developing world and analyzes the outcome and cost of treatment. Patients with medically intractable secondarily generalized epilepsy, bilateral nonfocal epileptic electroencephalogram (EEG), and absence of progressive encephalopathy were accepted as candidates (patients aged 0-30 years; 62 children, 19 girls and 43 boys, with mean age at surgery of 7.9 years; 35 adults, 19 women and 16 men, with mean age at surgery of 25.8 years). Preoperatively, the mean seizure frequency was 12.1 per day, or 364 per month (range, 0.06-200 per day, 1.8-6000 per month). Before surgery, 40% of patients were classified with generalized tonic-clonic seizures of different etiologies, or cryptogenic seizures; 36% had mixed seizures; 19% had Lennox-Gastaut Syndrome; and 5% had West Syndrome. Usually, routine EEG, computed tomography, and clinical findings sufficed for the surgical decision. The standard microsurgical technique performed was an anterior two-thirds CCS by the same surgeon under general anesthesia. In five cases, an additional frontal lobe excision after electrocorticography and subdural electrode monitoring was carried out in the same session. The results were evaluated after a mean follow-up of 35 months (range, 12-28). Two thirds of patients became seizure-free or were left with none or some disabling seizures. AED medication was eased slightly after surgery. The complication rate was low. The patients underwent postoperative psychosocial studies and neuropsychological rehabilitation and showed tendencies toward improvement. The direct cost of CCS in U.S. dollars (US$) ranged between 3,137 and 3,995 depending on the preoperative studies. Thus, CCS is well suited for selected patients in developing countries. Thus far, implantation of a vagus nerve stimulator has exceeded our economic possibilities in treating similar patients. Some reflections on care and research among epilepsy patients in developing countries are discussed.

Adolescent↗
PubMed1995

Epidemiology and practice of emergency medicine in a developing country.

STUDY OBJECTIVE: To analyze the emergency medicine system in a developing country and identify areas of need and potential collaboration. DESIGN: Convenience sample surveys of all emergency visits over a 2-week period, hospital admission and health department statistics, and interviews with government officials, health providers, and EMS managers. SETTING: Port of Spain General Hospital, Trinidad and Tobago. RESULTS: The ED has more than 100,000 visits per year. No records are kept. No physician in this study had emergency medicine training; only one had completed any residency. The survey included 3,710 patients: 40.5% were admitted, and .3% died. Injuries accounted for 41.6% of all visits, asthma 7.8%. The mean time elapsed before a patient was seen was .5 hour; mean time to discharge, 1.9 hours. In only 9% of patients were laboratory tests performed. Prehospital providers had limited equipment and training. CONCLUSION: The ED and prehospital systems provide high-volume and often high-acuteness care. Barriers to improved care include limited specialized training and lack of medical records.

Adolescent↗