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Biomedical subjects

R Peña

Publications and source records attributed to R Peña.

36 records · Page 2Linked to original sources
PubMed1996

Contraceptive patterns among women and men in León, Nicaragua.

The aim was to study the contraceptive patterns among men and women in León, Nicaragua. A questionnaire about sexual, contraceptive, reproductive and socioeconomic issues was directed to 7,789 households including 22% of all women of the municipality aged 15-49 years (n = 10,867). A subsample of 388 men and 413 women aged 15-49 years was drawn at random. Refusals were less than 2%. Private interviews revealed that among fertile women who had been sexually active within the last three months, non-pregnant and wishing to avoid pregnancy, 77% were contracepting. Female sterilization was the most common contraceptive method (39%), followed by intrauterine device (16%). Even though around 60% of women at some time had tried oral contraceptives, only 13% of contraceptors used them currently. The rhythm and interruption methods together constituted only 4%. Condom use was low and mainly occasional. Contraceptive use in sexually active women aged 15-44 years was lower among those having lower education, living in rural areas, and living under poverty conditions. The predominance of female sterilization and the occasional condom use-mainly reported by men-reflects a situation of relative male control over contraception and reproduction. This probably originates from "machista" values where men having many children with different women are considered strong. There was also a significantly higher use of contraceptives among the better-off women and men compared with the extremely poor. The situation of many poor women, in a country with limited contraceptive services, is worrying considering that abortion is illegal and the threat of HIV epidemic is growing. The situation for adolescents is particularly problematic with low experience in contraceptive use.

Adolescent↗
PubMed1994

Results from a community intervention project in the Nicaraguan mining community El Limon. An overview.

The first steps of a community involvement health project using the principles of community diagnosis and popular participation were carried out in a small Nicaraguan mining village during the second half of the 1980s. Using existing archives and obtaining new information aided by local organizations, priorities could be established for health and safety surveillance within the mining company, as well as for further investigations concerning what seemed to be dominant health problems in the community: serious accidents among the economically active population and diarrhoea and respiratory tract infections among children, as well as infections, and other health indicators of malnutrition. Workers also presented chronic simple bronchitis, ventilatory obstructive disturbance and hearing loss that were strongly associated with working conditions. These results helped to direct health priorities and educational activities at the local level with both the general and working population. The wide experience gained from this study has encouraged us to strengthen the link between research and action and in performing studies in close cooperation with local organizations.

Adult↗
PubMed1994

Antenatal cards--what should they contain?

An antenatal card should be designed to facilitate the early detection of important and clearly defined conditions, which in turn can result in well-defined and beneficial actions. The home-based antenatal card is a good instrument for having relevant information accessible at various antenatal visits, and also for transmitting the information to the delivery staff. If properly designed, it could also serve as an important means to assess epidemiological characteristics of the pregnant population, necessary for deciding priorities in a public health perspective. A cross-sectional study of women giving birth in León, Nicaragua, showed that the majority of the women could be classified as high-risk pregnancies. The present paper discusses the design of the Nicaraguan antenatal card, as well as its risk factors. A revision of the antenatal card and the accompanying manual is suggested, particularly with regard to the definitions of the high-risk criteria and the proposed action.

Adolescent↗
PubMed1994

A study of the use of the Nicaraguan antenatal card.

The present study describes the use of a home-based antenatal card in a sample of 120 consecutive women who were giving birth at a large teaching hospital in the city of León, Nicaragua. Information was obtained by interviews with the women before leaving hospital and all data on their antenatal cards and regarding delivery outcome were analysed. Antenatal care attendance by the 120 women was 93 per cent, and 86 per cent had received an antenatal card. However, only in 33 per cent of the cases had the card been adequately used: inappropriate handling in hospital was the commonest cause of non-use. Suggestions for a revision of the card are presented in the companion article, in which we also stress the importance of continuous training of the health personnel.

Adolescent↗
PubMed1992

[Atrioventricular and ventriculoarterial discordance (corrected transposition of the great vessels). Diagnosis with bidimensional echocardiography].

We present 15 patients with atrioventricular and ventriculoarterial discordance diagnosed with two-dimensional echocardiography from January 1973 to June 1991. The 15 had situs solitus and six dextrocardia. A different level of insertion of the atrioventricular valves worth from 0.77 +/- 0.3 cm, was observed in all the cases which didn't perimembranous inlet ventricular septal defect. Ten patients, presented septal insertion of one of the chords of the left atrioventricular valve, while, this insertion wasn't observed in the right atrioventricular valve. The ventricular morphology and trabeculation, permitted the identification of both ventricles in all the cases. The subxifoidea view resulted in being fundamental, for the examination of the ventriculoarterial connections. Ten cases (66.6%) had an obstruction in the pulmonary outflow tract (6 in the valve and 4 in subvalvular area) and nine (60%) ventricular septal defect (7 perimembranous and 2 muscular). We believe that the two-dimensional echocardiography gives enough information to arrive at the correct diagnosis of this cardiac malformation and of the associated anomalies. This information can be completed with the use of the color-flow Doppler.

Echocardiography↗
PubMed1992

[The double-chambered right ventricle: the surgical results in 28 cases].

Between May 1974 and June 1990, 28 double chambered right ventricle underwent surgical repair. Twenty-one (75%) had high obstructive anomalous muscle bundles and in seven (25%) the anomalous muscle bundles were in low position. A ventricular septal defect (VSD) was present in all cases and a subaortic stenosis in six. Longitudinal right ventriculotomy was performed in 15 (53.57%) patients and a combined pulmonary arteriotomy and right atriotomy was used in 13 (46.43%). In the group treated by ventriculotomy 2 patients died shortly after operation (one as a consequence of disseminated infection and one after a lung lobectomy); another patient developed patch dehiscence and reoperation was performed via right atrium a year after. In other 3 patients the Doppler revealed a residual gradient of 20 to 30 mmHg. There were no complications in the group of patients that underwent right atriotomy. In addition to resection of the anomalous muscle bundles, the associated cardiac anomalies were corrected in all patients. Follow-up of 5.5 +/- 3.8 years after operation showed that 26 (92.86%) patients were alive and asymptomatic. We conclude that double chambered right ventricle can be early repaired with good results using a combined procedure with right atriotomy and pulmonary arteriotomy.

Cardiac Catheterization↗
PubMed1990

Cross-sectional echocardiography in the diagnosis of atrioventricular septal defect.

Between 1983-1988 cross-sectional echocardiography was performed in 63 patients having an atrioventricular septal defect with common atrioventricular orifice. We excluded from this study all those patients with separate right and left orifices ("ostium primum" defects), those with isomerism of the right and left atrial appendages, those with univentricular atrioventricular connexions and those with discordant atrioventricular and ventriculo-arterial connexions. Parasternal long- and short-axis views, apical 4-chamber views and subcostal long-axis views were employed in all patients. In the last 26 cases, we also obtained the subcostal short-axis view. Nineteen patients showed ventricular dominance, with the right ventricle being dominant in 15. Ten patients had an associated defect in the oval fossa, while the atrial septum was partially or completely absent in the other 53. A ventricular septal defect was observed in all, but it was small in 10 and multiple in 2. Attachments of the superior and inferior bridging leaflets to the crest or the right side of the ventricular septum were seen in 32 cases. The inferior leaflet was hypoplastic in 19 patients. There was narrowing of the left ventricular outflow tract in 8 patients, and obstruction of the right ventricular outflow tract in 3. Abnormal attachment of the right portion of the common valvar orifice was present in 2 cases. A solitary papillary muscle supporting the left ventricular component of the common valve was seen in 6 cases producing a parachute-like arrangement. Our study shows that cross-sectional echocardiography is an excellent technique for the analysis of this anomaly.

Child, Preschool↗
PubMed1982

[Nasal tumors].

Explore the source record for details and available documents.

Child↗
PubMedDate not supplied

[Persistent truncus arteriosus. Echocardiographic study of 8 cases].

Eight patients (4 male, 4 female) with persistent truncs arteriosus diagnosed by two-dimensional echocardiography are presented. Age ranged from 1 to 19 days. Diagnosis was based on the demonstration of a single vessel giving rise to the aorta, pulmonary arteries and coronary circulation. In 6 patients we were able to define the types of the truncus: in 4 patients corresponded to type I (with partial presence of aorto-pulmonary septum) and in 2 cases corresponded to type II (without existence of septum). All cases had a dilated truncus (1.13 +/- 0.06 cm, range 1.05-1.3 cm), with moderate overriding (52% range 30%-65%) and an infundibular ventricular septal defect (0.6 +/- 0.08 cm, range 0.45-0.85 cm). In 2 cases we could also demonstrate the presence of an interruption of the aortic aorta. We conclude that two-dimensional echocardiography (specially parasternal long-short axis views and subcostal for right or leftout flow tracts axis views) gives sufficient information about this cardiac malformation, which can be completed by the use of pulsed Doppler ultrasound.

Echocardiography↗