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Biomedical subjects

W Flores

Publications and source records attributed to W Flores.

15 recordsLinked to original sources
PubMed2005

Epidemiology of transfusion-transmitted infections among multi-transfused patients in seven hospitals in Peru.

BACKGROUND: Transfusion-transmitted infections (TTIs) constitute a major health problem worldwide where routine screening of blood or blood products is improperly done, and where non-medical injecting medications and/or drug use are prevalent. Prevalence and risk factors vary by geographic location and by the specific TTI (including HIV-1, HBV, HCV and HTLV-I). OBJECTIVE: To determine the prevalence and risk factors associated with TTIs among a sample of multi-transfused adult patients in Peru. STUDY DESIGN: A cross-sectional multi-center study was conducted across seven major hospitals in Peru from February 2003 to September 2004. Self-reported behavior information (medical procedures, number of sexual partners, and drug use history) was analyzed, along with a review of exposure history from hospital medical records. Prevalences were calculated by TTI for different exposures, along with unadjusted and adjusted odds ratios for infection risk. RESULTS: Overall, 192 (54.7%) of 351 multi-transfused patients were found infected with one or more TTIs. Number of transfusion units, years of transfusion history (6 or more), and number of treatment facilities (2 or more) were associated with HCV infection. Hemodialysis history was a common risk factor associated with HBV, HCV and HTLV-I infection. HIV infection was associated only with total number of transfusion units received. CONCLUSIONS: High prevalences of HBV and HCV infection were found among Peruvian multi-transfused patients and were associated with a past history and number of blood transfusions, as well as with past hemodialysis procedures. TTIs continue to represent a significant public health problem in Peru. Continued vigilant attention to blood safety procedures, including universal screening and health care provider education, is recommended.

Adolescent↗
PubMed2003

Economic costs associated with inadequate drug prescribing: an exploratory study in Chiapas, Mexico.

An exploratory study assessing the economic consequences of inadequate prescribing by health-care providers was carried out in two cities of Chiapas State, South Mexico. Two research methods were used: (a) an exit survey with pharmacy users (1190 interviews) and (b) in-depth individual interviews with patients at hospital level (19 interviews). For comparative purposes, three tracer conditions were selected: acute respiratory infection (ARI), diarrhoeal disease (DD) and hypertension. The main findings were that doctors, drug vendors at pharmacies, traditional healers, users of health-care services themselves (through self-prescription) and other health staff are all sources of inadequate prescribing and impose a substantial economic burden of unnecessary cost on health-care users. In general, treatment costs were high compared with standard treatments, and prescriptions included a high proportion of non-essential drugs (50-64%). Additional costs to the standard treatment were particularly high when the prescription was by a medical doctor (US$ 3.57 per ARI prescription and US$ 8.37 for DD). Losses attributable to inadequate prescribing averaged US$ 47 per patient. The study concludes that training programmes on rational drug use aimed exclusively at medical doctors can only have a limited effect in reducing economic losses due to inadequate prescribing. Such efforts should be extended to other providers who are very active in prescribing drugs and providing health advice. The main challenge that the Mexican health system will be facing in the foreseeable future is not only to improve equity of access to essential drugs, but also to improve quality of drug advice and prescription and rational use of drugs by the population.

Adult↗
PubMed2001

Inadequate drug advice in the pharmacies of Guatemala and Mexico: the scale of the problem and explanatory factors.

A study of urban pharmacies in Guatemala and in Chiapas, southern Mexico, was undertaken to analyse the scale of the inadequate drug advice provided, and to identify the contributing factors. The estimate of the scale of the problem was based on the results of 969 approaches to 191 pharmacies by 'magic clients' (i.e. researchers pretending to be looking for treatment for relatives who had one of three 'tracer' diseases), interviews with 4469 pharmacy users as they left the same 191 pharmacies, and a comparison of the quality of advice offered by public and private pharmacies in Guatemala (based on exit interviews with 150 users). The contributing factors were explored using a provider survey (interviews with 166 pharmacy supervisors and 371 drug vendors), an in-depth study analysing large-chain and independent Mexican pharmacies, and a review of the national drug policies in both countries. Although only about 11% of all drug treatments were recommended in pharmacies (the rest being prescribed by physicians or recommended by kin-groups), this still represents large numbers of treatments. Overall, 501 individuals who visited the 191 study pharmacies over 2 days of observation received drugs recommended by pharmacy staff. Much of the pharmacy advice was revealed to be poor: > 80% of the treatments recommended to the 'magic clients' for diarrhoeal disease or acute respiratory infection included unnecessary or dangerous drugs. Few of those who worked in the pharmacies based their advice on careful case histories. Drug advice in pharmacies was much more likely to be of poor quality than that from physicians or even kin-groups. The factors behind this poor advice were identified as a lack of knowledge about standard treatments and legal regulations, incompetence among pharmacy staff, commercial pressures (particularly in the large-chain pharmacies of Mexico), and a failure to implement the existing regulations covering the drug market and its retail practices. It is recommended that: (1) pharmacy owners and drug vendors be made more aware that the selling of drugs should involve provision of healthcare (as well as reasonable profit-making); (2) existing drug-related legislation be reinforced (through consensus-building rather than coercion); and (3) mass training of pharmacy supervisors and drug vendors, in the standard treatment of common diseases, be undertaken. This process will be challenging and slow.

Clinical Competence↗
PubMed1999

Sonochemistry of quinones in argon-saturated aqueous solutions: enhanced cytochrome c reduction.

Sonolysis of argon-saturated aqueous quinone solutions resulted in an enhancement in ferricytochrome c (Cyt c) reduction. Upon addition of superoxide dismutase, Cyt c reduction was partially inhibited, thus implying a role of superoxide ion in this reduction process. Neither quinone hydrophobicity nor reduction potential exclusively controls the Cyt c reduction enhancement, although a preference for hydrophobicity versus reduction potential is noted.

Animals↗
PubMed1998

Putting evidence into practice.

A training module is described in which experienced health care managers from developing countries explore the challenges to be faced when attempting to use the results of systematic reviews of scientific studies on health care interventions in policy and practice.

Decision Making↗
PubMed1975

Ecologic studies of Venezuelan encephalitis virus in Peru during 1970-1971.

Venezuelan encephalitis (VE) virus has intermittently produced epidemics and equine epizootics on the dry Pacific coastal plain of Peru since at least the 1930's. However, evidence that the virus exists in the Amazon region of Peru to the east of the Andes mountains was not obtained until antibodies were found in human sera collected in 1965, and 10 strains of the virus were isolated in a forest near the city of Iquitos, Peru during February and March 1971. Eight strains came from mosquitoes and two from dead sentinel hamsters. Three hamsters exposed in forests near Iquitos developed VE virus antibodies suggesting that hamster-benign strains also exist there. Antibody tests of equine sera revealed no evidence that VE virus was actively cycling during the late 1950's or 1960's in southern coastal Peru, where equine epizootics had occurred in the 1930's and 1940's. In northern coastal Peru bordering Ecuador, antibodies were present in equine sera, presumably residual from the 1969 outbreak caused by subtype I virus, since neutralizing antibody titers were higher to subtype I virus than to subtypes III or IV. No VE virus was detected in this northern region during the dry season of 1970 by use of sentinel hamsters. The possibility is considered that VE epidemics and equine epizootics on the Pacific coast of Peru are caused by movements of virus in infected vertebrates traversing Andean passes or in infected vertebrates or mosquitoes carried in airplanes from the Amazon region.

Animals↗
PubMed1975

Degradation of benzothiophene and related compounds by a soil Pseudomonas in an oil-aqueous environment.

Pseudomonas aeruginosa PRG-1, an isolate from oil-contaminated soil, degrades benzothiophene (BT) and other related compounds in a 5% oil-basal medium system. The organism cannot grow on BT alone; 0.05% yeast extract is a suitable substrate for its growth and for its attack on BT. Although BT is partially toxic to the bacteria, toxicity is reduced when BT is added in this oil system. The oil phase is emulsified by bacterial action during the process. Oxygen uptake studies with washed cell suspensions show increased respiration in the presence of BT. Endogenous respiration is markedly decreased by p-hydroxy-mercuribenzoate, whereas respiration due to BT is scarcely affected, suggesting that oxygen is added directly to BT. Results obtained both in direct degradation and in respiration studies indicate that 3-methyl-thiophene is more rapidly and extensively degraded than BT and other related compounds.

Biodegradation, Environmental↗
PubMed1975

The prevalence of hepatitis B antigen among hepatitis patients and residents of Peru.

Single radial immune diffusion and counterelectrophoresis tests were used to examine 2,593 serum speciments from apparently healthy men, women, and children of Peru for the presence of hepatitis B antigen (Australia antigen). The object was to estimate the prevalence of the antigen in two contrasting geographic regions and to investigate the relationship between presence of the antigen and jungle hepatitis in eastern Peru. In connection with the latter goal, both single and serial serum samples collected from hepatitis cases during an epidemic in the northeast were also examined. Of the 2,593 apparently healthy subjects, the tests showed 1.4 per cent were carrying the antigen. However, when the data were broken down by geographic region it was found that 1.8 per cent of the subjects from eastern Peru were carriers, as compared to only 0.5 per cent of those from the northern coast. Moreover, incidences as high as 5 and 6.4 per cent were found in selected eastern areas, and a peak figure of 14.3 per cent was found in sera from children living in some of these areas. Comparison of the proportions of male and female sera positive for the antigen indicated that the proportion of males with HB Ag was nearly twice as high. However, sera collected from Indians of 20 different eastern tribes and from mestizos in the eastern region showed roughly the same proportion of samples positive for HB Ag in each ethnic group. The study also showed a close correlation between presence of the antigen and hepatitis infection during a 1972-1973 epidemic in eastern Peru. Testing of sera taken from hepatitis patients at that time showed many patients to be carrying HB Ag, specially in cases where serial blood samples were available. In all, positive test results were obtained for 81.2 per cent of the patients from whom two or more samples had been obtained.

Adolescent↗
PubMed1975

The first isolations of eastern encephalitis, group C, and Guama group arboviruses from the Peruvian Amazon region of western South America.

Two strains of eastern encephalitis (EE) virus were isolated in the Amazon region of Peru near Pucallpa, Loreto Department, using sentinel hamsters. EE virus antibodies were found in healthy horses at both Pucallpa and Iquitos in the same Department. Fourteen group C and four Guama group arboviruses were recovered from sentenel hamsters and mosquitoes near Iquitos. The group C agents were Caraparu-Ossa, Marituba, and Oriboca-Itaqui viruses, and the Guama group agents were Bimiti virus. Besides providing a detailed account of these investigations, this article includes a current list of known arboviruses of the American tropics that can be detected with sentinel hamsters.

Animals↗
PubMed1972

Arbovirus neutralization tests with Peruvian sera in Vero cell cultures.

Selected human sera from Peru, previously examined by the haemagglutination-inhibition (HI) test with a number of arboviruses, were reexamined by neutralization tests carried out in Vero cell cultures. Results confirmed and extended the HI findings, indicating that the antibodies detected were evoked by Eastern equine encephalitis, Mayaro, Venezuelan equine encephalitis, Ilheus, St Louis encephalitis, yellow fever, Caraparu, and Guaroa viruses.

Antibodies↗