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At least 1,153 records · Page 64Linked to original sources
PubMed2004

New features of rubella in Spain: the evidence of an outbreak.

In most of western Europe the rubella vaccine coverage is high. However, prior to the introduction of the vaccine in Latin America, rubella susceptibility in women of childbearing age was 10-25%. Forty one (93%) countries in Latin America have adopted the rubella vaccine since 2002. The adult immigrant population in Spain constitutes a group of susceptibles. In February 2003, the Madrid Community Measles Elimination Plan detected an increase in rubella notifications in women who had been born in Latin America. A descriptive study was undertaken to characterise the outbreak. A confirmed case was a person with fever or rash and a positive IgM serology, and living in Madrid, between 1 December 2002 and 31 March 2003. The secondary attack rate (SAR) per household was calculated. A total of 19 cases of rubella were identified, 15 were confirmed and 4 were probable cases. Fourteen (73.7%) cases were women at childbearing age. The mean age was 25.1 years. One pregnancy was diagnosed with a voluntary termination. Eleven (57.9%) cases were from Ecuador. The mean time of residence in Spain was 41 months. None of the cases or the 54 (78.3%) household contacts had been vaccinated against rubella. The SAR was 9.1%. This study showed the spread of rubella in the susceptible Latin American Community that is resident in Madrid. The interventions proposed were a vaccination programme towards immigrants, a health education campaign to prevent congenital rubella, and a health professional training programme case management.

Adolescent↗
PubMed2001

Redescription of Ammodytoides gilli, the tropical eastern Pacific sand lance (Perciformes: Ammodytidae).

Ammodytoides gilli (Bean, 1895) is the correct name for the tropical eastern Pacific sand lance. Its range is extended from Cabo San Lucas, Baja California south to Panama, Ecuador, and the Galapagos Islands. Ammodytes lucasanus Beebe and Tee-Van, 1938 is a junior synonym. Types of both nominal species were re-examined. The species is redescribed based on 50 specimens (42.3-115 mm SL) from 12 lots and is compared with other known species of Ammodytoides. Changes in ontogeny from the smallest known specimen (42.3 mm SL, illustrated) are detailed including reduction in the posterior dorsal fin lobe and development of branched dorsal and anal fin rays.

Animals↗
PubMedDate not supplied

[Validation of a screening questionnaire for stroke detection in Spanish-speaking communities].

OBJECTIVE: To evaluate the accuracy of an screening questionnaire for stroke detection in speaking-speaking communities. PATIENTS AND METHODS: We performed a door-to-door survey in Atahualpa (a rural community in coastal Ecuador) using a modified version of the Spanish translation of the OMS questionnaire for stroke detection. Subjects suspected of having a stroke as well as a 2% sample of negative subjects were evaluated by neurologists to evaluate sensitivity, specificity, and predictive value of the questionnaire and that of each of its questions. RESULTS: We found 18 possible cases among 1,568 individuals around 15 years old. Of these, 10 were confirmed stroke patients and 8 were false-positive (crude stroke prevalence of 6.38 per 1,000). We did not find false-negative cases. Sensitivity of the questionnaire was 100%, specificity was 99.5%, positive predictive value was 0.55 and negative predictive value was 1. The accuracy of each question as well as the number of questions answered as affirmative were different between patients and false-positive cases. CONCLUSIONS: The current questionnaire is highly sensitive but its positive predictive value is poor. This causes problems in large-scale studies, as the detection of many false-positives may compromise its viability. We propose a modification of the questionnaire that will turn it more accurate.

Adult↗
PubMed2003

Telemedicine in extreme environments: analogs for space flight.

The integration of telecommunications and information systems into health care delivery in human space flight operations is not new. It has been an integral tool for over 45 years. During these past decades, numerous efforts have been conducted to further develop and promulgate telemedicine. The National Aeronautics and Space Administration (NASA) established a commercial space center in 1997, known as the Medical Informatics and Technology Applications Consortium (MITAC). MITAC has developed and conducted a variety of test beds in several international settings, including Russia, Ecuador and other extreme and remote environments. These test beds have been designed to evaluate and validate technologies and techniques that have application in the delivery and support of health care in unique environments. The characteristics of these test beds are analogous to what might be observed or experienced in low earth orbit or on space-based platform. These include intermittent communications, low bandwidth, level of competency of the front line health worker, etc. These test beds have led to new approaches for the delivery of health care as well as enhanced education. These experiences have been beneficial in the promulgation of telemedicine as an effective tool and have provided new ideals for space exploration as well terrestrial medicine. This paper will highlight MITAC's test beds and their relationship to space exploration.

Animals↗
PubMed2004

[The real philanthropic expedition of the smallpox vaccine: monarchy and modernity in 1803].

Smallpox resulted in the death of 30 % of those who acquired it, so the preventive method discovered by Edward Jenner (London, 1798) spread very quickly. At the request in 1803 of Carlos IV, king of Spain, his government evaluated offers to carry smallpox vaccine to the colonies. The selected proposal, by doctor Francisco Xavier de Balmis, sought to take the lymph to America and Asia in a chain of arm to arm vaccination of foundlings. The Expedition set sail from Corunna on November 30, 1803, stopped in the Canary Isles, Puerto Rico, and Venezuela and after Caracas (1804) split in two groups. Balmis led some members of the Expedition to Cuba and Mexico. For the trip to the Philippines, in 1805, parents lent their children in exchange for economic compensation and the promise that the boys would be returned home. The Expedition returned to Mexico in August, 1807, but Balmis separately took vaccine to China and returned to Spain. Another contingent of the Expedition, under vice-director José Salvany, took vaccine to what we know as Colombia, Ecuador, Peru and Bolivia. His assistant Manuel Grajales reached the Chilean Patagonia in 1811. This article also comments on three principal themes - the institutional management of the scientific project, the conflicts that characterized its course, and the children's experience. The Vaccine Expedition was a brave and humanitarian endeavor, but also an extraordinary sanitary and administrative success. It was not until the twentieth century that a global eradication campaign eliminated smallpox in the world.

History, 19th Century↗
PubMed2005

Geographical Information Systems risk assessment models for zoonotic fascioliasis in the South American Andes region.

The WHO recognises Fasciola hepatica to be an important human health problem. The Andean countries of Peru, Bolivia and Chile are those most severely affected by this distomatosis, though areas of Ecuador, Colombia and Venezuela are also affected. As part of a multidisciplinary project, we present results of use of a Geographical Information Systems (GIS) forecast model to conduct an epidemiological analysis of human and animal fasciolosis in the central part of the Andes mountains. The GIS approach enabled us to develop a spatial and temporal epidemiological model to map the disease in the areas studied and to classify transmission risk into low, moderate and high risk areas so that areas requiring the implementation of control activities can be identified. Current results are available on a local scale for: (1) the northern Bolivian Altiplano, (2) Puno in the Peruvian Altiplano, (3) the Cajamarca and Mantaro Peruvian valleys, and (4) the Ecuadorian provinces of Azuay, Cotopaxi and Imbabura. Analysis of results demonstrated the validity of a forecast model that combines use of climatic data to calculate of forecast indices with remote sensing data, through the classification of Normalized Difference Vegetation Index (NDVI) maps.

Altitude↗
PubMedDate not supplied

[Usefulness of magnetic resonance angiography in surgery of ruptured intracranial aneurysms].

INTRODUCTION: Cerebral angiography (CA) is considered as the gold standard in diagnosis of intracranial aneurysms; nevertheless, the magnetic resonance angiography (MR-angiography) is wide spread used in detection of unruptured aneurysm. For this reason, several authors had proposed that MR-angiography could replace CA in the diagnosis of ruptured aneurysms. AIMS: To asses the efficacy of MR-angiography in diagnosis of ruptured intracranial aneurysms, and in addition to determine the safeness of its surgical management with MR-angiography alone. PATIENTS AND METHODS: We studied prospectively 52 patients with subarachnoid haemorrhage admitted at Teodoro Maldonado Carbo and Alcívar Guayaquil hospitals of Guayaquil, Ecuador, in a 5 years period. We compared the results of MR-angiography with CA and surgical findings in the diagnosis and categorization of intracranial aneurysms. RESULTS: We made diagnosis of 100% of 54 aneurysms with MR-angiography, while 98% with CA. The surgical findings were similar to the characteristics showed by MR-angiography. CONCLUSIONS: MR-angiography is an excellent no invasive method in the diagnosis of ruptured intracranial aneurysms, and could replace CA in selected cases.

Adult↗
PubMed1992

[The cholera epidemic in Latin America].

An outbreak of cholera started in Peru in January 1991 and spread through most Latin American countries within a year. This was the first known epidemic of cholera in America for more than a century. In 1991, 321,334 persons were reported to have cholera in Peru, 119,063 were hospitalized, and 2,906 died. Other countries like Ecuador, Colombia, Guatemala, Brazil, Mexico, Bolivia, Chile, El Salvador, Venezuela and Honduras were also affected, but these countries combined accounted for only 20% of the cases registered in Peru. In April 1992, all Latin American countries except Uruguay, Paraguay and French Guyana have reported cholera. The mortality rate for the epidemic in Latin America was only 1%, mainly owing to good oral rehydration treatment provided by Local health services and the Pan American Health Organization. The causative organism was Vibrio cholerae, serogroup O1, serotype Inaba (and Ogawa) of the El Tor biotype. Genetic characterization shows this strain to be unique, and the designation is reserved for the Latin American strain, distinguishing it from the other El Tor isolates from the 7th pandemic.

Cholera↗
PubMed1992

Demography of the human sex ratio in some Latin American countries, 1967-1986.

A sample based on hospital births recorded for the Latin American Collaborative Study on Congenital Malformations (ECLAMC) program was used in the present study to determine sex ratios for live births and for stillbirths. Sixty-four cities and 147 hospitals in 11 countries (Uruguay, Chile, Argentina, Brazil, Bolivia, Peru, Paraguay, Ecuador, Venezuela, Colombia, and Costa Rica) were included in the present analyses. The number of live births was 1,886,653 in the period 1967-1986, and the number of stillbirths was 24,818 in the period 1978-1986. The sex ratio for the total sample was 0.5112 for live births and 0.5477 for stillbirths. The sex ratio as a whole is decreasing with time in a parabolic fashion. Each country in our study behaved differently. Except for Peru and Uruguay, the countries experienced a significant decrease in the sex ratio after 1978 for live births; only Brazil did not show a temporal trend for the sex ratio for stillbirths.

Birth Rate↗
PubMedDate not supplied

Learning together: a Canada-Cuba research collaboration to improve the sustainable management of environmental health risks.

OBJECTIVE: To build a national Cuban capacity for training environmental health professionals directly linked to the needs of policy-makers and communities. PARTICIPANTS: The University of Manitoba and University of British Columbia collaborated with an established training centre in Cuba (the Instituto Nacional de Higiene y Epidemiologia--INHEM) and new centres in the Central (Santa Clara) and Eastern (Santiago) regions of the country. SETTING: Cuba. INTERVENTION: In the mid-1990s, a comprehensive curriculum (masters and diploma programs) was collaboratively developed, applying interactive teaching methods, and was delivered through a series of workshops and other interactions in Cuba, and short-term visits to Canada by Cuban PhD students. OUTCOMES: The collaboration was successful in fulfilling capacity-building targets (over 50 Masters graduates, 467 Diploma graduates, over 30 trained core faculty in all regional centres as well as new curriculum and new accredited regional programs). Alongside this, a number of collaborative community-based research projects were undertaken in all three regions (drinking water in Santiago; housing and urban renewal, and dengue control in Havana; and tourism-related effects, and effective intersectoral management of population health determinants in Santa Clara). CONCLUSION: The collaboration led to adopting new strategies for challenges such as a dengue epidemic in 2002, and new research on the effectiveness of intersectoral management of risks of particular interest to both Cuban and Canadian policy-makers. It triggered an ambitious collaboration between the Canadian-Cuban team and colleagues in Ecuador in order to build a similar national network there, built on South-South and North-South links.

Canada↗
PubMed2006

Molecular epidemiology of human immunodeficiency virus-infected individuals in Medellin, Colombia.

To study the molecular epidemiology of human immunodeficiency virus type 1 (HIV-1) strains in Medellín, Colombia, 115 HIV-1-positive individuals who were recruited from an HIV outpatient hospital (Universitario San Vicente de Paul) during the period from July 2001 to January 2002 were genotyped. All samples were analyzed by envelope heteroduplex mobility assay and found to be subtype B. Twenty-four samples were randomly selected for sequencing of the protease and the reverse transcriptase regions; all isolates were found to be subtype B. Phylogenetic analysis of seven nearly full-length genomes showed that all samples were subtype B. This study shows that the HIV epidemic in Colombia continues to be dominated by the subtype B virus. The predominance of subtype B genotypes of HIV-1 strains in Medellín resembles what is seen in the nearby countries of Peru, Ecuador, and Venezuela.

Adolescent↗
PubMed2005

Global suicide rates among young people aged 15-19.

Global suicide rates among adolescents in the 15-19 age group, according to the latest World Health Organization (WHO) Mortality Database, were examined. Data for this age group were available from 90 countries (in some cases areas) out of the 130 WHO member states. The mean suicide rate for this age group, based on data available for the latest year, was 7.4/100,000. Suicide rates were higher in males (10.5) than in females (4.1). This applies in almost all countries. The exceptions are China, Cuba, Ecuador, El Salvador and Sri Lanka, where the female suicide rate was higher than the male. In the 90 countries (areas) studied, suicide was the fourth leading cause of death among young males and the third for young females. Of the 132,423 deaths of young people in the 90 countries, suicide accounted for 9.1%. The trend of suicide rates from 26 countries (areas) with data available during the period 1965-1999 was also studied. A rising trend of suicide in young males was observed. This was particularly marked in the years before 1980 and in countries outside Europe. The WHO database is the largest of its kind and, indeed, the only information source that can currently be used for analysis of global mortality due to suicide. Methodological limitations are discussed.

Journal Article↗
PubMed1991

Update: cholera--Western Hemisphere, and recommendations for treatment of cholera.

Epidemic cholera appeared in Peru in January 1991 and subsequently spread to Ecuador, Colombia, Chile, Brazil, Mexico, and Guatemala. Cholera can be a severe, life-threatening illness but is highly preventable and easily treated; however, few health-care practitioners in the United States have experience identifying and treating cholera. This report provides an update on cholera in the Western Hemisphere and provides recommendations on the clinical diagnosis and treatment of cholera in the United States.

Adult↗
PubMed2006

Concomitant disseminated histoplasmosis and cryptococcosis in a person with AIDS.

A 46-year-old Hispanic male from Ecuador presented with fever, malaise, weight loss, and dyspnea. He was HIV-positive with a CD4+ cell count of 4/microL. He was hospitalized, and therapy for community-acquired pneumonia with broad-spectrum antibiotics was started. Both Histoplasma capsulatum and Cryptococcus neoformans were cultured from bronchial lavage, blood, and bone marrow specimens. Despite aggressive therapy with amphotericin B, the patient died 8 days after admission.

AIDS-Related Opportunistic Infections↗
PubMed1991

Prenatal diet, nutrient intake and pregnancy outcome in urban Ecuadorian primiparas.

A nutritional survey was conducted in an urban public maternity hospital, Hospital Gineco-Obstétrico Isidro Ayora (HGOIA), located in Quito, Ecuador. Seventy-four primiparas in the third trimester of pregnancy were recruited to assess the influence of sociedemographic factors on food patterns and nutrient intake, and the interrelationship between prenatal nutrient intake, maternal weight gain and pregnancy outcome. Results of the regression analysis indicated that maternal education was the factor most strongly associated with nutrient intake, followed by monthly per capita income. Maternal nutrient intake was next analyzed and compared with the WHO (1974, 1985) and NRC (1980) recommended daily allowances. Results also indicated the average daily intake of energy, protein, phosphorus, vitamins C and A, thiamine, riboflavin, and niacin met or exceeded the recommended daily allowances. Dietary calcium and iron intake, however, were below recommendations. Sodium and fat intake were both relatively high. Higher dietary fat intake was associated with increased birth weight, while lower protein intake was associated with increased risk of delivering a low-birth weight baby. Maternal weight gain during the third trimester predicted baby birth weight and height but not head circumference.

Feeding Behavior↗
PubMed1991

[Use of calcium for the prevention of pregnancy-induced hypertension].

The Andean population of Ecuador is exposed to major risk factors associated with pregnancy-induced hypertension (PIH). The disease is very frequent, and perinatal and maternal death rates are high. Recently a causal relationship has been suggested between dietary calcium deficiency and PIH, with the proposal that calcium supplements be given throughout pregnancy in order to prevent the disease. This article reviews a series of clinical tests carried out over a six-year period which have demonstrated that calcium supplementation is an effective low-cost measure for reducing the frequency of PIH in women whose intake of the mineral is low. It is not yet known how calcium reduces the risk of PIH. It is suggested that adequate intake of the mineral keeps serum levels of calcium within its narrow physiological limits; these are crucial for the synthesis of nitric oxide in the vascular endothelium, a substance that appears to be responsible for maintaining the vasodilatation that characterizes normal pregnancy. However, before the general use of calcium supplements can be recommended, it will be necessary to conduct epidemiological studies on larger numbers of women.

Animals↗
PubMed1991

[The treatment of chronic stable angina with isradipine. A cooperative Latin American study].

In order to study the efficacy and tolerance of isradipine, a new Ca++ antagonist for the treatment of stable chronic angina, a multicentric cooperative study was carried out in eight Latin American countries (Argentine, Chile, Colombia, Ecuador, Mexico, Peru, Uruguay and Venezuela), which included 169 patients (60% men and 40% women), average age 62.6 +/- 9.7. Patients with more than 4 biweekly anginal crisis were accepted, with one or more of the following inclusion criteria: coronariographic evidence of obstruction greater than 60% in one or more vessels, IAM history, positive scintigraphy and positive effort test. The trial was single-blind, with placebo during the admission phase (2 weeks) and active treatment for 12 weeks. isradipine was administered in increasing doses of 2.5, 5, and 7 mg thrice a day, according to the presence or absence of anginal crisis. It was observed that the average frequency of weekly pains decreased from 8.2 +/- 7 under placebo to 6.3 +/- 7.5 under isradipine at low doses, and to 2.0 +/- 2.0 (p less than 0.001) under maximum doses. TNT intake decreased parallel also in a significant way. At the end of the trial, 37% of patients had become asymptomatic, and angina had reduced to less than two crisis a week in 33%. A clear relation doses-effect was observed. There was no alteration in laboratory exams neither in ECG. Seven patients had complications derived from the evolutional course of disease (2 IAM, 5 unstable angina and one sudden death). Adverse events were relatively frequent and the majority derived from vasodilator effect (tibial oedema 37%, flushing 17%, headache 23%).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

[Andrés Bello and the royal philanthropic vaccine expedition].

In 1803 [corrected], Charles IV King of Spain, sent an expedition to perform widespread ("arm to arm") vaccination against smallpox in the American colonies. The expedition led by Dr Francisco Javier de Belmis visited Puerto Rico, Venezuela, Central America, Colombia, Ecuador, Perú, Bolivia and Chile. A poem to the vaccine was written by Andres Bello, the first rector of the University of Chile, then in Venezuela (1804). The expedition reached Chile in 1807, led by Dr Julián Grajales. This expedition was the most important medical act in the history of the Spanish colonies.

Famous Persons↗