Browsing by Autor "Vargas, R"

Now showing 1 - 2 of 2

A survey of prescribing patterns for tuberculosis treatment amongst doctors in a Bolivian city.
(1999) Ollé-Goig, J E; Cullity, J E; Vargas, R
SETTING: A sample survey of knowledge about prescribing tuberculosis treatment among private physicians in the city of Santa Cruz, Bolivia. OBJECTIVES: To study the anti-tuberculosis regimens prescribed by private physicians and to assess the number of tuberculosis patients treated by them. DESIGN: Questionnaire survey of a random sample of 401 private physicians in Santa Cruz. RESULTS: Of the 401 physicians, 165 (41%) could not be located or did not want to participate. Among the 236 completed questionnaires, 137 physicians (58%) stated that they did not see patients with tuberculosis, 16 (7%) referred them to other centres and 83 (35%) treated them in their practice. Among 80 prescribed regimens that could be evaluated there were 58 different regimens: 17 (21%) followed the National Tuberculosis Control Programme's standard regimen, but overall 35 regimens (60%) were incorrect-18 regimens (31%) were non-curative and 17 (29%) could not be recommended. Frequent errors were the prescription of medications not available in the market (7%) or not included in the national regimen (34%), the prescription of insufficient medications (9%), or of only one in the continuation phase (16%), or for too short (9%), or too long (12%) a period. Eighty physicians estimated that they attended in their practice an average total of 404 patients with tuberculosis per month. CONCLUSIONS: A significant number of physicians in private practice did not adhere to the standard norms for prescribing anti-tuberculosis treatment. This study also suggests that in the city of Santa Cruz, Bolivia, there is a not insignificant number of patients with tuberculosis treated outside the National Tuberculosis Control Programme.
Preeclampsia and risk of maternal pulmonary hypertension at high altitude in Bolivia.
(2023) Salinas, C E; Patey, O V; Murillo, C; Gonzales, M; Espinoza, V; Mendoza, S; Ruiz, R; Vargas, R; Perez, Y; Montaño, J; Toledo-Jaldin, L; Badner, A; Jimenez, J; Peñaranda, J; Romero, C; Aguilar, M; Riveros, L; Arana, I; Giussani, D A
Women with a history of preeclampsia (PE) have a greater risk of pulmonary arterial hypertension (PAH). In turn, pregnancy at high altitude is a risk factor for PE. However, whether women who develop PE during highland pregnancy are at risk of PAH before and after birth has not been investigated. We tested the hypothesis that during highland pregnancy, women who develop PE are at greater risk of PAH compared to women undergoing healthy highland pregnancies. The study was on 140 women in La Paz, Bolivia (3640m). Women undergoing healthy highland pregnancy were controls (C, n = 70; 29 ± 3.3 years old, mean±SD). Women diagnosed with PE were the experimental group (PE, n = 70, 31 ± 2 years old). Conventional (B- and M-mode, PW Doppler) and modern (pulsed wave tissue Doppler imaging) ultrasound were applied for cardiovascular íííassessment. Spirometry determined maternal lung function. Assessments occurred at 35 ± 4 weeks of pregnancy and 6 ± 0.3 weeks after birth. Relative to highland controls, highland PE women had enlarged right ventricular (RV) and right atrial chamber sizes, greater pulmonary artery dimensions and increased estimated RV contractility, pulmonary artery pressure and pulmonary vascular resistance. Highland PE women had lower values for peripheral oxygen saturation, forced expiratory flow and the bronchial permeability index. Differences remained 6 weeks after birth. Therefore, women who develop PE at high altitude are at greater risk of PAH before and long after birth. Hence, women with a history of PE at high altitude have an increased cardiovascular risk that transcends the systemic circulation to include the pulmonary vascular bed.