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Biomedical subjects

C A Alvarez

Publications and source records attributed to C A Alvarez.

At least 19 recordsLinked to original sources

Current status of onchocerciasis in Colombia.

To assess the current epidemiologic status of onchocerciasis in Colombia two surveys were undertaken in 1995 in a suspected new focus on the border between Colombia and Ecuador and in the known focus located on the Micay River. No new focus was found along the Colombia-Ecuador border. In the known focus, communities along the upper Micay River and its tributaries were surveyed; 655 adults underwent physical examinations and skin biopsies. Infected individuals were found almost exclusively in the community of Naiciona, where prevalence of infection was 40% (36 of 91). Polymerase chain reaction detection of onchocercal DNA in skin snips correlated with the skin-snip biopsy results. The prevalence of punctate keratitis, the only ocular manifestation found, was 33%. A rapid entomologic assessment demonstrated Simulium exiguum infected with Onchocerca volvulus. This is the first finding in Colombia of naturally infected black flies and confirms S. exiguum as a vector species. These data will be used for implementing a control program using periodic ivermectin distribution.

Adolescent

Predictors of first-contact care in a poor urban community.

OBJECTIVE: The aim of the study was to identify predictors of first-contact care in a population of poor urban residents. METHODS: Information from a community health needs survey was used for the study. The sample included adult residents in five urban census tracts with a large proportion of Puerto Rican Hispanics. Potential predictors included social characteristics, source of health insurance, perceived health status, number of chronic diseases, use of alternatives to medical care, smoking status, and problems with alcohol use. RESULTS: A total of 826 household interviews were completed for a participation rate of 78% among eligible households. Individuals with no health insurance were six times more likely to lack a source of first-contact care, compared with those who have traditional indemnity insurance. Those who only had Medicaid were four times more likely to lack a source of first-contact care. Respondents involved in Medicaid-managed care programs had similar access to first-contact care as those with commercial insurance. Individuals who reported problems with alcohol were three times more likely to lack a source of first-contact care. CONCLUSIONS: Health insurance is an important predictor of access to first-contact care for poor urban residents. Those who identify problems with alcohol and African-Americans have additional difficulty with access to first-contact care.

Adult

Quantitative pathology of the intraepithelial laryngeal neoplasia.

A clinical-histologic and morphometric study on 32 patients with precancerous laryngeal lesions was carried out. Two biopsies taken at different times were studied, and the cases in which carcinoma developed were compared with those cases in which it did not. The only clinical-histologic variable with prognostic value, related with evolution to carcinoma, was severe dysplasia. The Malignancy Grading System, which grouped together 13 clinical-histologic variables, had both high sensitivity and high specificity. On the other hand, quantitative microscopy was a more sensitive and objective method. Through the relationship between the parameters of orientation/nuclearity and Histometric Progression Index, we could separate those cases in which invasive carcinoma developed from those cases in which it did not with a sensitivity of 100% and a specificity of 82%.

Adult

American medical students broaden their horizons in the Third World.

Every year for several decades some American medical students have been visiting Third World countries in order to participate in the practices there. These experiences have proved invaluable in helping them to work in the USA among minorities having unorthodox views on health and disease.

Developing Countries