Common mental disorders in public transportation drivers in Lima, Peru.

BACKGROUND: Traffic related injuries are leading contributors to burden of disease worldwide. In developing countries a high proportion of them can be attributed to public transportation vehicles. Several mental disorders including alcohol and drug abuse, psychotic disorders, mental stress, productivity pressure, and low monetary income were found predictors of high rates of traffic related injuries in public transportation drivers. The goal of this study was to estimate the prevalence of common mental disorders in the population of public transportation drivers of buses and rickshaws in Lima, Peru. METHODOLOGY/PRINCIPAL FINDINGS: Cross sectional study. A sample of bus and rickshaw drivers was systematically selected from formal public transportation companies using a snowball approach. Participants completed self-administered questionnaires for assessing major depressive episode, anxiety symptoms, alcohol abuse, and burnout syndrome. Socio demographic information was also collected. The analyses consisted of descriptive measurement of outcomes taking into account both between and within cluster standard deviation (BCSD and WCSD). A total of 278 bus and 227 rickshaw drivers out of 25 companies agreed to participate in the study. BCSD for major depressive episode, anxiety symptoms and burnout syndrome was not found significant (p>0.05). The estimated prevalence of each variable was 13.7% (IC95%: 10.7-16.6%), 24.1% (IC95%: 19.4-28.8%) and 14.1% (IC95%: 10.8-17.4%) respectively. The estimated prevalence of alcohol abuse was 75.4% (IC95%: 69-81.7%, BCSD = 12.2%, WCSD = 41.9%, intra class correlation (ICC): 7.8%). CONCLUSION: Common mental disorders such as alcohol abuse, major depressive episode, anxiety symptoms and burnout syndrome presented higher rates in public transportation drivers than general population.

Association of major depressive episode with negative outcomes of tuberculosis treatment.

BACKGROUND: Pulmonary tuberculosis (TB) persists an important contributor to the burden of diseases in developing countries. TB control success is based on the patient's compliance to the treatment. Depressive disorders have been negatively associated with compliance of therapeutic schemes for chronic diseases. This study aimed to estimate the significance and magnitude of major depressive episode as a hazard factor for negative outcomes (NO), including abandon or death in patients receiving TB treatment. METHODOLOGY/PRINCIPAL FINDINGS: A longitudinal study was conducted to evaluate the association of major depressive episode (MDE), as measured by a 5-item version of the Center for Epidemiological Studies Depression Scale (CES-D) with NO to TB treatment. Patients with confirmed TB were enrolled before the start of TB treatment. Baseline measurements included socio-demographic variables as well as the CES-D, which was also applied every month until the end of the treatment. Death and treatment default were assessed monthly. Survivor function (SF) for NO according to MDE status (CES-D≥6) at baseline (MDEb) was estimated. Cox's Regression was performed for bivariate analyses as well as for the multivariate model. A total of 325 patients accepted to participate in the study, of which 34 where excluded for diagnosis of MDR-TB. NO was observed in 24 patients (8.2%); 109 (37%) presented MDEb. Statistically significant difference was found on the SF of patients with and without MDEb (0.85 vs. 0.96, p-value = 0.002). The hazard ratio for NO, controlled for age, sex, marital status and instruction level was 3.54 (95%CI 1.43-8.75; p-value = 0.006). CONCLUSION: The presence of MDE at baseline is associated to NO of TB treatment. Targeting detection and treatment of MDE may improve TB treatment outcomes.

Excessive sleepiness prevalence in public transportation drivers of a developing country.

OBJECTIVE: To determine the prevalence of excessive sleepiness (ES) in bus and auto-rickshaw drivers from Lima, Peru. METHODS: We conducted a cross-sectional study of Lima's bus and auto-rickshaw drivers to estimate ES prevalence in this population. Survey sites were private transportation companies, systematically selected with a snowball approach. ES was assessed with the Spanish-validated version of the Epworth sleep questionnaire (ESQ) with a cutoff score >10. We obtained relevant demographic information. RESULTS: Four hundred and thirty-four bus and auto-rickshaw drivers were eligible for analysis. The overall ES prevalence was 32.7 percent (95% confidence interval [CI]: 28-37.2). ES prevalence was higher in bus drivers than in auto-rickshaw drivers, 38 percent (95% CI: 31.7-44.2) and 26.9 percent (95% CI: 20.6-33.1), respectively (P = .01). We used data from all subjects to obtain regression equations for ESQ score with several predictors. Being a bus driver, working additional nighttime hours per week, having depression or anxiety, and alcohol abuse had small but significant associations with ESQ scores. CONCLUSION: ES prevalence in Lima's public transportation drivers is in a medium range as suggested by previous regional studies.

Atención médica y prevención de depresión en un hospital nacional / Prevention and medical assistance of depression in a national hospital

Se revisa la depresión y su prevención en un hospital nacional, Hospital Hipólito Unanue, con énfasis en los niveles de atención que ameritan intervención oportuna, esto es diagnóstico apropiado y tratamiento eficaz. Se presentan datos estadísticos del servicio de psiquiatría que dan énfasis a lo expuesto y se rescata un modelo integrativo de atención con formulación de sugerencias.

Complicación de la fiebre tifoidea en niños: Anasarca. Reporte de un caso y revisión de la literatura / Anasarca as a typhoid fever complication in children. Report of case and review of the literature

Reportamos el caso de un niño de 9 años con fiebre tifoidea y múltiples complicaciones, incluyendo anasarca que no es mencionada en la literatura mundial. Discutimos los hallazgos de este paciente

Foco permanente de fiebre amarilla en el Valle del Río Apurímac, Ayacucho, Perú, y primer aislamiento del virus de la fiebre amarilla en ese país / A continuing focus of yellow fever in the Apurimac River Valley, Ayacucho, Peru, and the first isolation of yellow fever virus in that country

En 1977 ocurrió en el sur de Perú un extenso brote de una enfermedad hemorrágica que correspondía a la fiebre amarilla, y a pesar de uma amplia campaña de vacunación hubieron brotes recurrentes en años posteriores. Las circunstacias epidemiológicas en que acaecieron estos brotes indican que un importante factor determinante fue el ingreso, repetido anualmente, de trabajadores migratorios susceptibles en un foco enzootico de esta enfermedad. Durante el estudio de dichos brotes los autores intentaron aislar el virus de la fiebre amarilla de muestras de sangre obtenidas de seis pacientes en 1977, cuatro en 1978 y cuatro en 1981, en la zona endémica. Con este propósito se inyectó sangre entera de los pacientes a ratones lactantes (por via intracraneal), y se inocularon ademas cultivos de celulas C6/36 (Aedes albopictus), ratones lactantes, LLCMK2 y Vero. Las cepas del virus aisladas de seis de estos pacientes se identificaron posteriormente como agentes causales de la fiebre amarilla, y es esta la primera vez que se logra aislar el virus en Perú

Foco permanente de fiebre amarilla en el valle del río Apurimac, Ayacucho, Perú, y primer aislamiento del virus de la fiebre amarilla en ese país / A. continuing focus of yellow fever in the Apurimac River Valley, Ayacucho, Peru, and the first isolation of yellow fever virus in that country

En 1977, 1978 y 1981 ocurrieron en el sur del Perú extensos brotes, cuyas circunstancias epidemiológicas aquí se describen, de una enfermedad hemorrágica que correspondía a la fiebre amarilla. Es esta la primera vez que se logra aislar el virus en el Perú, por lo que se detallan los procedimientos empleados en seis pacientes (AU)

Patología del hombre nativo de las grandes alturas : Investigación de las causas de muerte en 300 autopsias / Pathology of natives of high altitudes : Investigation of the causes of death in 300 autopsies

The authors give the results of autopsies on 300 persons native to our living in the city of Cerro de Pasco, Peru, which is situated at an altitude of 14,300 ft, and in adjacent villages

With the exception of infant diseases, the most frequent causes of death are diseases of the respiratory system. Of these, pneumonia and bronchopneumonia occupy the first place, and their incidence is higher than that observed at sea-level. Among infectious diseases, tuberculosis occupies the first place. The findings also show that at high altitudes intestinal obstruction by volvulus is more frequent in adults than at sea-level

Another significant finding was the frequency in adults of vascular lesions of the central nervous system, the rate of which was higher than that observed at sea-level. In addition, hemorrohagic complication of various types of lesions, especially of the respiratory and digestive systems, both in adults and in children, are more frequent at high altitudes than at sea-level(AU)

Patología del hombre nativo de las grandes alturas : Investigación de las causas de muerte en 300 autopsias / Pathology of natives of high altitudes : Investigation of the causes of death in 300 autopsies

The authors give the results of autopsies on 300 persons native to our living in the city of Cerro de Pasco, Peru, which is situated at an altitude of 14,300 ft, and in adjacent villages

With the exception of infant diseases, the most frequent causes of death are diseases of the respiratory system. Of these, pneumonia and bronchopneumonia occupy the first place, and their incidence is higher than that observed at sea-level. Among infectious diseases, tuberculosis occupies the first place. The findings also show that at high altitudes intestinal obstruction by volvulus is more frequent in adults than at sea-level

Another significant finding was the frequency in adults of vascular lesions of the central nervous system, the rate of which was higher than that observed at sea-level. In addition, hemorrohagic complication of various types of lesions, especially of the respiratory and digestive systems, both in adults and in children, are more frequent at high altitudes than at sea-level(AU)

Foco permanente de fiebre amarilla en el valle del río Apurimac, Ayacucho, Perú, y primer aislamiento del virus de la fiebre amarilla en ese país / A. continuing focus of yellow fever in the Apurimac River Valley, Ayacucho, Peru, and the first isolation of yellow fever virus in that country

En 1977, 1978 y 1981 ocurrieron en el sur del Perú extensos brotes, cuyas circunstancias epidemiológicas aquí se describen, de una enfermedad hemorrágica que correspondía a la fiebre amarilla. Es esta la primera vez que se logra aislar el virus en el Perú, por lo que se detallan los procedimientos empleados en seis pacientes (AU)