Search

Objective: To analyse life-threatening obstetric complications that occurred in public hospitals in Argentina., Design: Multicentre collaborative cross-sectional study., Setting: Twenty-five hospitals included in the Perinatal Network of Buenos Aires Metropolitan Area., Population: Women giving birth in participating hospitals during a 1-year period., Methods: All cases of severe maternal morbidity (SMM) and maternal mortality (MM) during pregnancy (including miscarriage and induced abortion), labour and puerperium were included. Data were collected prospectively., Main Outcome Measures: Identification criteria, main causes and incidence of SMM; case-fatality rates, morbidity-mortality index and effective intervention's use rate., Results: A total of 552 women with life-threatening conditions were identified: 518 with SMM, 34 with MM. Identification criteria for SMM were case-management (48.9%), organ dysfunction (15.2%) and mixed criteria (35.9%). Incidence of SMM was 0.8% (95% confidence interval [95% CI] 0.73-0.87%) and hospital maternal death ratio was 52.3 per 100 000 live births (95% CI 35.5-69.1). Main causes of MM were abortion complications and puerperal sepsis; main causes of SMM were postpartum haemorrhage and hypertension. Overall case-fatality rate was 6.2% (95% CI 4.4-8.6): the highest due to sepsis (14.8%) and abortion complications (13.3%). Morbidity-mortality index was 15:1 (95% CI 7.5-30.8). Use rate of known effective interventions to prevent or treat main causes of MM and SMM was 52.3% (95% CI 46.9-57.7)., Conclusions: This study describes the importance of life-threatening obstetric complications that took place in public hospitals with comprehensive obstetric care and the low utilisation of known effective interventions that may decrease rates of SMM and MM. It also provides arguments that justify the need to develop a surveillance system for SMM., (© 2013 RCOG.)

Bacterial agents causing diarrea in patients attended in a hospital of Rosario, Argentina. The frequency of bacterial agents causing diarrhea can vary in patients of different areas, and through the time. In an epidemiological surveillance we studied 304 patients with diarrheal diseases looking for Salmonella enterica, Shigella spp, Campylobacter spp, Aeromonas spp, Yersinia enterocolitica, and diarrheogenic Escherichia coli. C. jejuni was isolated in 30 patients (9,9 %), Salmonella in 18 (5,9 %), and enteropathogenic E. coli (EPEC) in 7 (2,3 %). Most cases due ton C. jejuni had mucus and/or blood in their feces. Unexpectedly we didn't fine any cases due to Shigella spp. There was much less cases due to EPEC than in our previous studies, and occurred only in children of less than 5 years old. It is necesary to take in consideration that C. jejuni cause nearly all the cases of diarrhea in patients with mucus and blood in their feces actually in our region.

Objective: To provide reliable data on the incidence of insulin-dependent diabetes mellitus (IDDM) in children (< 15 years of age) in Avellaneda, Argentina., Research Design and Methods: A registry was established in Avellaneda, Argentina. The first registry was started in 1989, retrospective data collection was updated from 1985 to 1988, and prospective data was collected from 1989 to the present. The data were collected according to the World Health Organization Diabetes Mondiale (DIAMOND) protocol. Primary ascertainment was based on personal interviews at schools, and secondary sources were pediatric hospitals and private diabetologists., Results: The IDDM incidence per 10,000 children in the studied population was as follows: for 1985, 6.89; for 1986, 6.90; for 1987, 6.91; for 1988, 5.29; for 1989, 6.42; and for 1990, 7.59. Of those children, 51.7% reported previous infection or stress as a possible trigger factor. No sex preference, age incidence peak, or seasonal trend was found., Conclusions: The study documents an incidence rate of childhood IDDM in Avellaneda, Argentina, similar to other Occidental countries.

An interview system was used to survey 56,199 students in Avellaneda between the ages of 3 and 20 years, representing 60.6% of the population of that age group in the census. The study covered 178 of the 201 pre-schools, grade schools, high schools and special schools in the area. Thirty three diabetic children were identified (18 girls, 15 boys), with a mean of 12.5 years of age. This represents a prevalence of diabetes in the school age population of 0.45/1000 in the 3-12 year old group, 1.25/1000 in the 13-20 year old group, with 0.59/1000 for the total of children surveyed. (93.82 of ascertainement, 95% CI 0.34 to 0.42/1000). Similar figures have resulted from studies in developed countries. The most frequent initial symptoms were the typical ones, with only 15% showing acidosis or diabetic coma as the initiation of the illness. Viral infections and stress appeared to be related to the onset of the disease. Diabetes was in the family history of 48.5% of the diabetic children, and 24.5% of the non-diabetics. The most common diabetic relative was the paternal grandfather. The maternal side showed a higher number of diabetic relatives with preponderance of males. No socio-economic differences were found between diabetics and non-diabetics.