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C Cabezas

Publications and source records attributed to C Cabezas.

35 records · Page 2Linked to original sources
PubMed1995

Aggravation of parkinsonian tremor by cisapride.

Cisapride, a substituted piperidinyl benzamide that is chemically related to metoclopramide, is a prokinetic agent that facilitates motility of the gastrointestinal tract (1). The mechanism by which cisapride exerts its actions is not clear. It enhances acetylcholine release in the myenteric plexus of the gut, and evidence exists that it has an agonistic action on a serotonin receptor, probably the 5-HT4 receptor (2). The drug is well tolerated, and no central nervous system side effects have been reported. We describe two patients with parkinsonism who experienced aggravation of tremor while on therapy with cisapride.

Aged↗
PubMed1995

Immunogenicity in Peruvian volunteers of a booster dose of oral cholera vaccine consisting of whole cells plus recombinant B subunit.

Forty-nine subjects received two doses of oral cholera vaccine consisting of whole cells plus recombinant B subunit; this was followed by a booster dose one year later. After the primary series, a significant (greater than twofold) increase in the levels of vibriocidal, anti-cholera toxin immunoglobulin G and anti-cholera toxin immunoglobulin A antibodies occurred in 54, 88, and 81% of the subjects, respectively. Within one year, titers decreased to levels close to baseline. A booster dose then induced rises to those which occurred after the initial vaccination. The results suggest that 1-year booster doses may be necessary to maintain immunity against cholera in Latin America.

Administration, Oral↗
PubMed1994

Protective efficacy of oral whole-cell/recombinant-B-subunit cholera vaccine in Peruvian military recruits.

The cholera epidemic in South America has reinforced the need for safe and effective oral vaccines. In a randomised, double-blind, placebo-controlled efficacy trial among 1563 Peruvian military recruits we have investigated the protective efficacy of an oral inactivated whole-cell/recombinant-B-subunit (WC/rBS) cholera vaccine. Participants were given two oral doses of cholera vaccine or Escherichia coli K12 placebo, with an interval of 7-14 days. 1426 (91%) subjects received the two prescribed doses and were followed up for a mean of 18 weeks (median 21 weeks). After vaccination, Vibrio cholerae O1 El Tor Ogawa was isolated from 17 subjects with diarrhoea. 16 of the cholera cases occurred 2 weeks or longer after the second dose of vaccine (14 placebo recipients, 2 vaccinees). We also detected 14 symptomless infections (11 [7 placebo recipients, 4 vaccinees]) 2 weeks or longer after the second dose. The vaccine had significant protective efficacy against cholera (86% [95% CI 37-97], p < 0.01) but not against symptomless infection (42% [-96 to 85]). All cholera cases were in people of blood group O, who made up 76% of the study population (p < 0.01). Two doses of WC/rBS vaccine, given 1 to 2 weeks apart, provide rapid, short-term protection against symptomatic cholera in adult South Americans, who are predominantly of blood group O. Long-term efficacy studies in Peruvian adults and children are under way.

ABO Blood-Group System↗
PubMed1992

Does nurse counseling or offer of nicotine gum improve the effectiveness of physician smoking-cessation advice?

Medical advice and use of nicotine gum have recently received increased attention as effective tools to encourage smokers to quit, yet the relative value of nurse vs physician counseling has not been explored in depth. In this study, 425 smokers attending three urban primary care centers in Barcelona were systematically allocated to one of three groups: group A patients received a brief counseling session to quit from their family physician; group B patients were given the same brief counseling along with a free supply of nicotine gum; group C received a brief health-education session from the primary care nurse. Three hundred forty-nine patients (82%) could be reached by telephone at the two-month follow up. By that time, after correcting for the estimated validity of the phone report of smoking status, the proportion declaring themselves to be nonsmokers was 10.9%, 11.1%, and 10.8%, respectively, without significant differences between them. At one-year follow up the proportions were 4.4%, 5.3%, and 6.0%. In the logistic regression analysis, only the expected difficulty of quitting was predictive of one-year abstention, OR = 3.1 (95% CI: 1.3-7.3). The present study shows no difference between physician versus nurse counseling and no improvement in the proportion of quitters with the addition of nicotine gum in the physician-counseled group.

Adult↗
PubMed1992

Do knowledge and attitudes about influenza and its immunization affect the likelihood of obtaining immunization?

A telephone survey was conducted on 190 patients in Barcelona, Spain, at high-risk for influenza to evaluate the relationship between their knowledge and attitudes toward influenza and influenza immunization and whether they received the immunization. A discriminant function correlates (r = 0.86) with the immunization behavior and predicts the behavior before flu immunization in 84% of cases if we know the previous immunization behavior and adequately classifies the behavior in 82% if we don't know it (r = 0.75). Modifiable factors that predict immunization are self-identification as high-risk, belief that the immunization will not cause discomfort, intention to be immunized, and physician assigned. Those not immunized had a prevalent feeling that the shot is not effective, that they are not susceptible to the illness, and that the health center does not offer satisfactory organization to provide immunization. Furthermore, they felt that they had received controversial information through the mass media. We therefore believe that health education activities regarding influenza immunization should be specifically directed to increasing awareness of those who belong to a high-risk group, as well as to emphasizing susceptibility to the illness and the innocuousness of the immunization.

Aged↗
PubMed1991

[Priorities in prevention and health promotion in primary health care: views of the professionals].

The aim of the study was to define the health problems, preventive and promotional activities, and self care measures which have a high priority for the primary care professionals in our area. A Delphi study with two rounds of questionnaires. A 69.6% of a panel of professionals selected because of their remarkable degree of participation in clinical, educational, organizational or managerial activities in PHC participated in the study. Chronic diseases and the mental health disorders of the anxiety/depression type were considered the most important health problems. The detection and control of hypertension, medical counseling against smoking, and the compliance with the vaccination schedules were the most supported preventive interventions. Finally, the consulted professionals felt that it is necessary to promote self care in chronic diseases and in some acute conditions such as upper respiratory infections. The primary health care professionals considered as interventions with a high priority for health promotion the counseling of life style and the traditional interventions such as the compliance with the vaccination schedules of the hypertension programs. It is necessary to adapt the training of professionals to the priorities in PHC problems and activities.

Attitude of Health Personnel↗
PubMed1990

[Medical counseling, nursing counseling, and nicotine chewing gum for smoking cessation in primary care].

The 2-month results of a study designed to compare the effectiveness of three methods to encourage giving up smoking in primary health care are reported: individualized medical counseling (minimal intervention), counseling plus follow-up option by the nurse, and medical counseling plus nicotine chewing gum. Overall 425 smokers between 15 and 65 years of age were included in the study. In 349 of them (82%), short term follow-up was carried out by phone interview. The proportion who declared to have given up smoking, after adjustment for the estimated validity of the phone report of smoking status, was 10, 9%, 10.8% and 11.1%, respectively, without significant differences between the three groups. In the logistic regression analysis, only the existence of concomitant disease and the anticipated difficulty in giving up smoking appeared as predictive variables of abstention. The implications of the results for the strategies to control smoking are discussed.

Adolescent↗
PubMed1989

[Compliance of antibiotic treatment in primary health care. Value of the personalized prescription].

A controlled clinical study was carried out in order to evaluate the efficacy of a personalized prescription as a measure to improve the fulfillment of a short course antibiotic treatment. 180 patients completed the study (96 in the active group and 88 in the control group) finding no differences in selected variables between the two groups. Evaluation of treatment fulfillment was performed with an interview and counting the pills, finding with this method that 57.94% of the patients fulfilled the treatment. Except for a higher incidence of adverse side effects in the control group (p less than 0.05) no other significant differences were found between the two groups. The interview showed a 37% sensibility and a 97% specificity, which was specially usefull in the detection of nonfulfillers. The correlation coefficient between both groups was 0.66 (p less than 0.001). Our results suggest that the personalized prescription does not improve the patient compliance achieved by a good verbal information in the short course antibiotic treatment.

Adult↗
PubMedDate not supplied

[Side effects of antithrombotic treatment in the secondary prevention of cerebrovascular disease].

OBJECTIVE: To determine the incidence of adverse effects of antithrombotic drugs (platelet anti-aggregants and anticoagulants) in patients with transient ischemic attacks (TIA) and mild ischemic strokes (IL). PATIENTS AND METHODS: Clinical follow-up data on the patients with TIA and IL included in a community-based observational study undertaken in the province of Segovia. Adverse effects which led to suspension of treatment or were a potential danger for the patient's life were recorded. RESULTS: The groups studied included 235 patients and the average initial age was 70.8 years. The average follow-up time was 3.6 years. The treatment initially given included: aspirin (75.7%), ticlopidine (12.8%) and acenocumarol (9.4%). Adverse effects led to suspension of treatment in 6% (5% with aspirin and acenocumarol, 17% with ticlopidine). The adverse effects of ticlopidine were mild and patients did not need admission to hospital (cutaneous exanthema, diarrhoea and reversible leucopenia). Aspirin was associated with digestive tract bleeding (2.8%) and cerebral hemorrhage (1.7%) which required hospital admission in most cases. One patient treated with acenocumarol presented with a retroperitoneal hematoma. CONCLUSIONS: In general antithrombotic drugs are well-tolerated by patients with TIA and LI. Hemorrhagic complications, particularly of the digestive tract, associated with aspirin limit tolerance to it.

Acenocoumarol↗
PubMedDate not supplied

[Hepatitis B among health workers].

BACKGROUND: Hepatitis B virus (HBV) infection is one of the infectious diseases whose elimination or eradication is possible. However, it is still a serious problem among health workers who are an important risk group to acquire this infection. OBJECTIVE: To focus the problem of the HBV infection among health workers in terms of the risks and prevention alternatives, showing effective strategies to this effect. DATA SOURCE: Analysis of related publications through the MEDLINE system and the review of scientific journals, both in English and Spanish. SYNTHESIS OF INFORMATION: An available and effective vaccine against HBV exist more than 10 years ago. Some national hospitals have demonstrated the prevalence of HBV infection in apparently healthy staff, which evidences that it is an occupational problem. The vaccination of this risk group has proved to reduce the HBV infection in several centers in different countries, in addition to the cost-effectiveness of this measure. CONCLUSION: HBV infection constitutes a significant problem in our country considering its intermediate high endemic rate. No effective measures for its control have been taken, despite the availability of effective vaccines and strategies for the control and prevention of this disease, not to mention their economic benefits.

Aged↗
PubMedDate not supplied

[Prevalence of serological markers of viral hepatitis A, B and delta in apparently healthy schoolchildren of Huanta, Peru].

UNLABELLED: Huanta is an Andean valley of Peru, located at 2400 meters above sea level with a population of 45,000 inhabitants. Viral hepatitis is widely known in the area due to its severe clinical symptoms and high morbidity and mortality. METHODS: A study on the prevalence of hepatitis A, B and D markers among 143 clinically healthy school students was carried out. The students were selected randomly from 4 schools in the city. The subjects provided epidemiological data regarding viral hepatitis and a venous blood sample to determine HBsAg, anti HBc antibody, anti-HBc IgM, anti HAV and anti HDV by the ELISA technique (Abbott Lab.). RESULTS: A total of 93 males and 50 females participated in the study. The mean age was 13.2 years (7-20 y.). Anti HAV was detected in 140 of them (98%). Prior infection by HBV was detected in 117 (82%) and an active infection in 4 of them (2.7%). The rate of HBsAg carriers was 16.0% (23). HDV infection was found in 21 of 117 (17.9%) individuals infected by the HBV. HBV infection and the previous use of injections represented a significant association (OR:3.7 IC 1.3-11, p < 0.012). No differences in sex were noted. CONCLUSION: A high prevalence of HAV, HBV, and HDV was found among school students in Huanta and this was the first report of hepatitis delta in the area. The association of HBV infection and the use of injections was meaningful. The high prevalence of HBV and HDV suggests the existence of a relationship to the morbidity and mortality by hepatitis in Huanta, thus the need for control programs by means of immunization against HBV.

Adolescent↗
PubMedDate not supplied

[Pilot program of immunization against viral hepatitis B, integrated in the extended immunization program in Abancay (peru)].

INTRODUCTION: Abancay is located at 2,395 m.a.s.l. in the Peruvian Andean Region. It is a hyperendemic area for Hepatitis B virus (HBV) and hepatitis delta virus (HDV) infection, where 7% of the deaths are caused by acute and chronic hepatitis infections. In 1991, a pilot immunization program against HBV infection was started to control the incidence of VHB-VHD, and as a strategy to improve the EPI coverage in general. METHODS: Vaccination population was programmed to include 1,301 children under 1 year old and 3,488 children between 1-4 years old. A total of 3 doses of DNA recombinant vaccine against HBV per child were administered. The vaccination schedule fit within the EPI immunization schedule. For children under one year old, the program includes: Newborn: BCG, Polio 1, HBV1; 2-month old: Polio 2, DPT1, HBV2; 3-month old: DPT2, Polio 3; 4-month old: polio 4, HBV 3 and; 9 month old: Measles. For children aged between 1 and 4 years old, the program includes: HBV1, HBV2 one month after HBV1, and HBV six months after HBV1. RESULTS: One year after the immunization program started, 1,262 (97.0%) children under one year old and 2,529 (72.5%) between 1-4 years old were immunized. No relevant adverse effects have been reported. There were 8 deaths due to acute respiratory infection and acute diarrhea diseases, which are the main causes of death in this area. One of the objectives achieved was an improvement in the EPI vaccination coverage for children younger than 1 year old, with a DPT coverage of 97.0% in 1991 compared to 63.0% in 1988, 26.9% in 1989, and 61.9% in 1990. CONCLUSION: The inclusion of HVB vaccination in the EPI for a HBV and HDV endemic area improves the total EPI coverage and it is safe an effective.

Child, Preschool↗