92 results on '"Jaime R. Torres"'
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2. Are the first 1,000 days of life a neglected vital period to prevent the impact on maternal and infant morbimortality of infectious diseases in Latin America? Proceedings of a workshop of experts from the Latin American Pediatric Infectious Diseases Society, SLIPE
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Roberto Debbag, Jaime R. Torres, Luiza H. Falleiros-Arlant, Maria L. Avila-Aguero, Jose Brea-del Castillo, Angela Gentile, Xavier Saez-Llorens, Abiel Mascarenas, Flor M. Munoz, Juan P. Torres, Liliana Vazquez, Marco A. Safadi, Carlos Espinal, Rolando Ulloa-Gutierrez, Monica Pujadas, Pio Lopez, Eduardo López-Medina, and Octavio Ramilo
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first 1,000 days of life ,pregnancy immunization ,infant immunization ,pediatric ,social determinants of health ,Pediatrics ,RJ1-570 - Abstract
While the first 1,000 days of life are a critical period in child's development, limited information on the main determinants affecting this period in the Latin America and the Caribbean (LAC) region is available. Therefore, the Latin American Pediatric Infectious Diseases Society (SLIPE) held an ad hoc workshop in May 2022 with an expert panel designed to analyze the main factors impacting the development of childhood in the region during this period and the main causes of maternal infant morbimortality. The aim was to identify priorities, generate recommendations, and advise practical actions to improve this situation. Considerations were made about the challenges involved in bridging the gap that separates the region from more developed countries regarding an optimal early childhood and maternal care. Extensive discussion was conducted to reach consensus recommendations on general strategies intended to reduce maternal and infant mortality associated with infections and immune-preventable diseases during the first 1,000 days of life in LAC.
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- 2023
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3. Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series
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Fhabián S. Carrión-Nessi, Daniela L. Mendoza-Millán, Óscar D. Omaña-Ávila, Sinibaldo R. Romero, Augusto Moncada-Ortega, Mary Lopez-Perez, Jaime R. Torres, Óscar Noya-González, and David A. Forero-Peña
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Case series ,COVID-19 ,Malaria ,Plasmodium vivax ,SARS-CoV-2 ,Venezuela ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Abstract Background Malaria‐endemic areas are not spared from the impact of coronavirus disease 2019 (COVID-19), leading to co-infection scenarios where overlapping symptoms impose serious diagnostic challenges. Current knowledge on Plasmodium spp. and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co‐infection in pregnant women remains limited, especially in Latin America, where Plasmodium vivax infection is highly prevalent. Methods This is a case series of five pregnant women with P. vivax and SARS-CoV-2 co-infection hospitalized in two main malaria referral centers of the Capital District and Bolivar state, Venezuela between March 13, 2020 and December 31, 2021. Results Clinical and laboratory data from five pregnant women with a mean age of 22 years were analyzed; three of them were in the third trimester of pregnancy. Comorbidities included obesity in two cases, hypertension in one, and asthma in one. Three out of five patients had severe to critical COVID-19 disease. Dry cough, fever, chills, and headache were the most frequent symptoms reported. Laboratory analyses showed elevated aspartate/alanine aminotransferase and creatinine levels, thrombocytopenia, and severe anemia as the most relevant abnormalities. The mean period between symptom onset and a positive molecular test for SARS-CoV-2 infection or positive microscopy for Plasmodium spp. was 4.8 ± 2.5 days and 2.8 ± 1.6 days, respectively. The mean hospital stay was 5.4 ± 7 days. Three women recovered and were discharged from the hospital. Two women died, one from cerebral malaria and one from respiratory failure. Three adverse fetal outcomes were registered, two miscarriages and one stillbirth. Conclusion This study documented a predominance of severe/critical COVID-19 disease and a high proportion of adverse maternal–fetal outcomes among pregnant women with malaria and COVID-19 co-infection. More comprehensive prospective cohort studies are warranted to explore the risk factors, management challenges, and clinical outcomes of pregnant women with this co-infection.
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- 2023
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4. DENGUE/COVID-19, EPIDEMIOLOGICAL AND CLINICAL INTERACTIONS
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Jaime R. Torres
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Infectious and parasitic diseases ,RC109-216 - Abstract
COVID-19 pandemic is an important public health concern in dengue endemic areas due to overlapping of clinical and laboratory features, representing a significant challenge for health care providers that often hampers a correct diagnosis and management of both diseases. Therefore, during the COVID-19 pandemic, healthcare providers in areas where dengue is endemic or who treat patients with recent travel history to these areas, need to consider dengue and COVID-19 in the differential diagnosis of acute febrile illnesses.Global Implications and Opportunities and COVID-19 have mild illness and do not require hospitalization, both diseases can cause severe illness that may result in death. Indeed, clinical management for people with severe illness due to either of these two diseases is quite different, often requiring hospital-based care.High index of suspicion is necessary in handling COVID-19 cases in tropical setting where dengue is endemic. Acute febrile cases with leucopenia and thrombocytopenia should be screened for dengue. Since false positive dengue serology or cross-reactivity with SARS-Cov-2 infections are known to occur, and have a potential impact on clinical outcome, or else, result in delay in COVID-19 or dengue appropriate treatment, the risk of occurrence of complications and death is increased.
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- 2023
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5. THE CHIKUNGUNYA PANDEMIC IN LATIN AMERICA: LEARNING ON THE FLY
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Jaime R. Torres
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Infectious and parasitic diseases ,RC109-216 - Abstract
Chikungunya virus (CHIKV) emerged in the Americas in late 2013 as a cause of extensive acute and chronic morbidity. More than 2.9 million suspected cases of chikungunya (CHIK) were reported the following year, including severe cases and deaths. High disease attack rates were reported in areas such as in the Dominican Republic, (41%) or Suriname (90.4%), and the transmission peak was reached within 3 months. Disease burden of chikungunya remains unclear owing to inadequate disease surveillance and underdiagnosis. Virus evolution, globalization, and climate change may further CHIKV spread. No approved vaccine or antiviral therapeutics exist. Early detection and appropriate management could reduce the burden of severe atypical and chronic arthritic disease. Improved surveillance and risk assessment are needed to mitigate the impact of chikungunya.Due to the occurrence of unexpected clinical features and complications, newer CHIK case definitions had to be developed for the Americas.The experience with the CHIK pandemic in the region allowed for a better understanding of the epidemiology and clinical spectrum of the disease. The lessons learned will help the Americas not only to better comprehend the acute and chronic phases of the disease, but also to improve the follow up of at-risk population groups.
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- 2023
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6. Improving Middle-Income Countries Access to Vaccines. A Blueprint to Overcome Current Challenges
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Carlos Espinal, Francisco Becerra-Posada, and Jaime R. Torres
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vaccine access ,vaccine research ,vaccine innovation ,research and development ,Infectious and parasitic diseases ,RC109-216 ,Public aspects of medicine ,RA1-1270 - Abstract
The Global Health Consortium at Florida International University developed an end-to-end solution framework based on the input of a diverse panel of experts from middle-income country (MIC) government agencies, public health think tanks, academia, and nonprofit organizations to identify mechanisms to help MIC governments and stakeholders increase access to novel vaccines for infectious diseases. The resultant layout can be deployed to improve vaccine discovery and development, strengthen regulatory processes, and boost vaccine production, access, and implementation. Mechanisms include policies and incentives MIC governments can use to stimulate vaccine investment and activity, as well as actions government agencies can take together with other stakeholders to coordinate efforts or build capabilities. Through a series of individual virtual interviews, we engaged diverse experts from MIC government agencies, public health think tanks, academia, and nonprofit organizations who understand the vaccine ecosystem, immunization policies, and population health financing at global, regional, and country levels. Responses were mapped, and in-depth questions were prepared for a group virtual discussion. This paper is the result of such a group discussion. The panel identified clear opportunities for MICs to improve locally-driven innovations and future access to novel vaccines. It proposes a solution framework for countries considering investing in vaccine research and development and innovation to use as a guide to evaluate the steps they could take to improve such an environment and incentivize innovation in vaccine development. It is hoped that this end-to-end solution framework will become a key resource to help MICs strengthen policies and take more actions to make such improvements.
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- 2023
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7. HTLV-1 uveitis in Colombia, an underrecognized complication of a hitherto neglected condition: a case series
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Wilmer Villamil-Gomez, Jaime R. Torres, Juan Rojas-Hernández, Jose Ignacio Restom Merlano, Jairo Vergara-Corena, Patricia Salgado, Jorge Viloria-Ruiz, Alvaro Castro, Andrés Mauricio Cabrera Lasso, and Eduardo Gotuzzo
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Infectious and parasitic diseases ,RC109-216 - Abstract
Three Colombian patients with chronic HTLV-1 infection and severe intermediate and/or posterior uveitis are described. In one case, retinal ablation was necessary due to extensive peripheral degeneration, while the other two were successfully managed with local anti-inflammatory therapy. Gradual resolution of ocular findings was observed in all three patients on follow-up. Uveitis is a rarely recognized late complication of this infection, which represents a diagnostic and therapeutic challenge for clinicians in endemic countries. The real extension of HTLV-1 prevalence in Colombia and the frequency of its ophthalmologic complications remain to be determined.
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- 2023
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8. Latin America: Situation and preparedness facing the multi-country human monkeypox outbreak
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Alfonso J. Rodriguez-Morales, Gustavo Lopardo, Sergio Verbanaz, Tomas Orduna, Susana Lloveras, Jose María Azeñas-Burgoa, Juan Pablo Escalera-Antezana, Lucia Elena Alvarado-Arnez, Alexandre Naime Barbosa, Fredi Diaz-Quijano, Sergio Cimerman, Tânia do Socorro Souza Chaves, Andrea G. Rodriguez-Morales, Cecilia Perret, Claudio A. Méndez, Jorge A. Riera, D. Katterine Bonilla-Aldana, German Camacho-Moreno, Henry Mendoza, Ivan Arturo Rodriguez-Sabogal, Jose Oñate, Angel A. Escobedo, Monica Thormann, Yori Roque, Patricia Gabriela Zambrano, Yenddy Carrero, Nancy Sandoval, Lysien Zambrano, Carlos Franco-Paredes, Enrique Chacon-Cruz, Iván Lopez-Delgado, Cesar Cuadra-Sánchez, Monica Pachar-Flores, Ricardo Correa, Hernan D. Rodriguez-Enciso, Veronica Rotela-Fisch, Julio Maquera-Afaray, Percy Herrera-Añazco, Vicente Benites-Zapata, Eduardo Savio-Larriera, Juan David Ramírez, Alberto Paniz-Mondolfi, Alejandro Risquez, David A. Forero-Peña, Jaime R. Torres, and Jose Antonio Suarez
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Public aspects of medicine ,RA1-1270 - Published
- 2022
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9. The ever changing landscape of Zika virus infection. Learning on the fly
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Jaime R. Torres, Jorge Murillo, and Lina Bofill
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Infectious and parasitic diseases ,RC109-216 - Published
- 2016
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10. Congenital and perinatal complications of chikungunya fever: a Latin American experience
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Jaime R. Torres, Luiza H. Falleiros-Arlant, Lourdes Dueñas, Jorge Pleitez-Navarrete, Doris M. Salgado, and José Brea-Del Castillo
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Chikungunya ,Perinatal ,Congenital ,Latin America ,Complications ,Infectious and parasitic diseases ,RC109-216 - Abstract
Background: During the years 2014 and 2015, the Region of the Americas underwent a devastating epidemic of chikungunya virus (CHIKV) of the Asian genotype, resulting in millions of affected individuals. However, epidemiological and clinical information on this experience is scarce. Prior knowledge of congenital and neonatal illness caused by CHIKV is limited and almost exclusively based on data obtained from a single outbreak of the East/Central/South African (ECSA) genotype. The effect of chikungunya fever (CHIKF) on pregnancy outcomes and its consequences for infants born to infected mothers at the peak of the epidemic wave in Latin America are reviewed herein. Epidemiological and clinical data on maternal and neonatal infections were collected prospectively and analyzed. Methods: One hundred sixty-nine symptomatic newborns with CHIKF seen at four large regional maternity hospitals in three different Central and South American countries were evaluated prospectively. The outcomes of pregnancies in symptomatic infected mothers at two of these clinical centers were also analyzed. Results: The observed vertical transmission rate ranged between 27.7% and 48.29%. The incidence of congenital disease was unrelated to the use of cesarean section or natural delivery. The case fatality rate (CFR) at the only center that reported deaths was 5.3%. The most common clinical manifestations included fever, irritability, rash, hyperalgesia syndrome, diffuse limb edema, meningoencephalitis, and bullous dermatitis. Severe complications included meningoencephalitis, myocarditis, seizures, and acute respiratory failure. Leukocytosis with neutrophilia and normal or increased platelets was a common finding, and in those with signs of meningeal involvement, moderate lymphocytic pleocytosis with normal glucose and protein levels was typical. Conclusions: This study presents the largest number of symptomatic neonates with CHIKF analyzed so far in any region and is the first involving infection with the Asian genotype of CHIKV. Although the clinical manifestations found were similar to those reported previously, the percentage of neurological complications was lower. The CFR was comparatively high. Chikungunya represented a substantial risk for neonates born to symptomatic parturients during the chikungunya outbreak in the Americas Region, with important clinical and public health implications.
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- 2016
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11. Congenital Chagas’ disease transmission in the United States: Diagnosis in adulthood
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Jorge Murillo, MD FACP, Lina M. Bofill, MD MPH FACP, Hector Bolivar, MD, Carlos Torres-Viera, MD MPH, Julio A. Urbina, PhD, Daniel Benhayon, MD, and Jaime R. Torres, MD MPHTM
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Chagas disease ,Pregnancy ,Transmission ,Congenital ,Infectious and parasitic diseases ,RC109-216 - Abstract
Two brothers with congenitally-acquired Chagas’ disease (CD) diagnosed during adulthood are reported. The patients were born in the USA to a mother from Bolivia who on subsequent assessment was found to be serologically positive for Trypanosoma cruzi. Serologic screening of all pregnant women who migrated from countries with endemic CD is strongly recommended.
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- 2016
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12. Chikungunya fever: Atypical and lethal cases in the Western hemisphere
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Jaime R. Torres, Códova G. Leopoldo, Julio S. Castro, Libsen Rodríguez, Víctor Saravia, Joanne Arvelaez, Antonio Ríos-Fabra, María A. Longhi, and Melania Marcano
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Chikungunya fever ,Severe ,Hemorrhagic fever ,Western hemisphere ,Infectious and parasitic diseases ,RC109-216 - Abstract
A large epidemic of Chikungunya fever currently affects the Caribbean, Central and South America. Despite a high number of reported cases, little is known on the occurrence of severe clinical complications. We describe four Venezuelan patients with a severe and/or lethal course who exhibit unusual manifestations of the disease. Case 1 describes a 75 year-old man with rapid onset of septic shock and multi-organ failure. Cases 2 and 3 describe two patients with rapid aggressive clinical course who developed shock, severe purpuric lesions and a distinct area large of necrosis in the nasal region. Case 4 depicts a splenectomized woman with shock, generalized purpuric lesions, bullous dermatosis and acronecrosis of an upper limb. Chikungunya fever in the Western hemisphere may also associate with atypical and severe manifestations. Some patients experience a life-threatening, aggressive clinical course, with rapid deterioration and death due to multisystem failure.
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- 2015
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13. Family Cluster of Mayaro Fever, Venezuela
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Jaime R. Torres, Kevin L. Russell, Clovis Vasquez, Robert B. Tesh, Rosalba Salas, and Douglas M. Watts
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Mayaro ,Arbovirus ,ELISA ,enzyme-linked immunosorbent assay ,Venezuela ,Febrile Illness ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
A cluster of protracted migratory polyarthritis involving four adult family members occurred in January 2000 after a brief overnight outing in a rural area of Venezuela. Laboratory testing demonstrated Mayaro virus as the cause of the cluster. These results documented the first human cases of Mayaro virus in Venezuela.
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- 2004
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14. Microhematospermia in acute Zika virus infection
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Jaime R. Torres, Nahir Martínez, and Zoila Moros
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Infectious and parasitic diseases ,RC109-216 - Published
- 2016
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15. The health and economic impact of dengue in Latin America El impacto sanitario y económico del dengue en Latinoamérica
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Jaime R. Torres and Julio Castro
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Dengue ,Factores de Riesgo ,Costos de la Atención en Salud ,Risk Factors ,Health Care Costs ,Medicine ,Public aspects of medicine ,RA1-1270 - Abstract
In the last two decades, all countries in the tropical regions of Latin America have experienced marked increases in the incidence of both classic dengue and dengue hemorrhagic fever. Major risk factors for the occurrence of dengue in the region, as well as some regional peculiarities in its clinical expression, such as the extensive involvement of older age groups, have been defined. While little information exists on the economic impact of dengue in the region in terms of disease burden, the estimated loss associated with the disease is on the same order of magnitude as tuberculosis, sexually transmitted diseases (excluding HIV/AIDS), Chagas disease, leishmaniasis, or intestinal helminths. Therefore, similar priority should be given in the allocation of resources for dengue research and control. Data on cost-efficacy and cost-benefit analysis of dengue control programs in Latin America are scarce; however, the cost per DALY averted by control programs during endemic periods appears low, as compared to other mosquito-borne diseases like yellow fever, leishmaniasis, or malaria. Additionally, the cost-benefit ratio of the control programs has proven to be positive.En las últimas dos décadas, todos los países de las regiones tropicales de Latinoamérica han registrado un fuerte aumento en la incidencia de dengue clásica y dengue hemorrágica. Ya fueron identificados los principales factores de riesgo para la ocurrencia de dengue en la región, así como algunas peculiaridades regionales en su expresión clínica, como el comprometimiento frecuente de grupos de la tercera edad. Pese a la falta de información sobre el impacto económico del dengue en la región en términos de gastos por la enfermedad, las pérdidas estimadas asociadas con la misma son del mismo orden de magnitud que los de la tuberculosis, enfermedades sexualmente transmisibles (excluyendo VIH/SIDA), enfermedad de Chagas, leishmaniasis o parasitosis intestinales. Por tanto, la investigación y control del dengue merecen niveles de prioridad semejantes a las de otras enfermedades en términos de asignación de recursos. Los datos son escasos sobre los análisis de coste-eficacia y coste-beneficio de los programas de control del dengue en Latinoamérica; sin embargo, parece ser bajo el coste por AVAI evitado a través de programas de control durante períodos endémicos, en comparación con otras enfermedades transmitidas por mosquitos, como la fiebre amarilla, leishmaniasis o malaria. Asimismo, ya se comprobó la correlación positiva coste-beneficio de los programas de control.
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- 2007
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16. Seizures and Praziquantel. A case report
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Jaime R. Torres R., Oscar Noya G., Belkysyolé A. de Noya, and Alejandro Mondolfi G.
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Praziquantel ,Seizures ,Neurocysticercosis ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
A 27 year Old male developed seizures after receiving a single 20 mg/kg dose of praziquantel for the treatment of an intestinal Hymenolepis nana infection. On further clinical and laboratorial evaluations, he was found to suffer from an until then asymptomatic parenchymal brain cysticercosis. Praziquantel must be used with caution in those areas where cysticercosis represents a mayor public health problem. The occurrence of unexpected seizures in an individual being treated with the compound, must prompt clinicians to rule out cysticercosis of the CNS.
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- 1988
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17. Treatment of Cutaneous Larva Migrans with albendazole: preliminary report
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Jaime R. Torres R., Angel R. Orihuela, David Garcia, and Salha Abdul-Hadi
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Cutaneous larva migrans ,Treatment ,Albendazole ,Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Abstract
Twenty three patients with Cutaneous Larva Migrans syndrome were prospectively treated with 400 mg/day of Albendazole for 3 consecutive days. Clinical response, compliance and tolerance was excellent. Patients were asymptomatic within the first 72 hours of treatment and recurrences did not occurred. Preliminary results with three additional patients suggest that a single oral 400 mg dose may be effective as well.
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- 1989
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18. Use of praziquantel in populations at risk of neurocysticercosis
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Jaime R. Torres R.
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Arctic medicine. Tropical medicine ,RC955-962 ,Infectious and parasitic diseases ,RC109-216 - Published
- 1989
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19. Declaración SLIPE: Aumento de la cobertura antipoliomielítica con vacunas más seguras: una urgencia inaplazable en Latinoamérica
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Luiza H. Falleiros-Arlant, María L. Avila-Agüero, José Brea-del Castillo, Angela Gentile, Jaime R. Torres, and Debbag Roberto
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Infectious Diseases ,Public Health, Environmental and Occupational Health - Published
- 2022
20. Increasing polio coverage with safer vaccines: a pressing need in Latin America
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Luiza H. Falleiros-Arlant, Jaime R. Torres, María L. Ávila-Agüero, José Brea-del Castillo, Angela Gentile, and Roberto Debbag
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Infectious Diseases ,Public Health, Environmental and Occupational Health - Published
- 2022
21. Google dengue trends: An indicator of epidemic behavior. The Venezuelan Case.
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Ricardo A. Strauss, Julio S. Castro, Ralf Reintjes, and Jaime R. Torres
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- 2017
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22. Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women:a case series
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Fhabián S. Carrión-Nessi, Daniela L. Mendoza-Millán, Óscar D. Omaña-Ávila, Sinibaldo R. Romero, Augusto Moncada-Ortega, Mary Lopez-Perez, Jaime R. Torres, Óscar Noya-González, and David A. Forero-Peña
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Adult ,Pregnancy Complications, Infectious/diagnosis ,COVID-19/diagnosis ,SARS-CoV-2 ,Malaria, Vivax/diagnosis ,Malaria ,Abortion, Spontaneous ,Young Adult ,Infectious Diseases ,Pregnancy ,Humans ,Parasitology ,Female ,Pregnant Women ,Prospective Studies ,Plasmodium vivax ,Venezuela/epidemiology ,Coinfection/diagnosis - Abstract
Background Malaria‐endemic areas are not spared from the impact of coronavirus disease 2019 (COVID-19), leading to co-infection scenarios where overlapping symptoms impose serious diagnostic challenges. Current knowledge on Plasmodium spp. and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co‐infection in pregnant women remains limited, especially in Latin America, where Plasmodium vivax infection is highly prevalent. Methods This is a case series of five pregnant women with P. vivax and SARS-CoV-2 co-infection hospitalized in two main malaria referral centers of the Capital District and Bolivar state, Venezuela between March 13, 2020 and December 31, 2021. Results Clinical and laboratory data from five pregnant women with a mean age of 22 years were analyzed; three of them were in the third trimester of pregnancy. Comorbidities included obesity in two cases, hypertension in one, and asthma in one. Three out of five patients had severe to critical COVID-19 disease. Dry cough, fever, chills, and headache were the most frequent symptoms reported. Laboratory analyses showed elevated aspartate/alanine aminotransferase and creatinine levels, thrombocytopenia, and severe anemia as the most relevant abnormalities. The mean period between symptom onset and a positive molecular test for SARS-CoV-2 infection or positive microscopy for Plasmodium spp. was 4.8 ± 2.5 days and 2.8 ± 1.6 days, respectively. The mean hospital stay was 5.4 ± 7 days. Three women recovered and were discharged from the hospital. Two women died, one from cerebral malaria and one from respiratory failure. Three adverse fetal outcomes were registered, two miscarriages and one stillbirth. Conclusion This study documented a predominance of severe/critical COVID-19 disease and a high proportion of adverse maternal–fetal outcomes among pregnant women with malaria and COVID-19 co-infection. More comprehensive prospective cohort studies are warranted to explore the risk factors, management challenges, and clinical outcomes of pregnant women with this co-infection.
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- 2023
23. Plasmodium vivax and SARS-CoV-2 co-infection in Venezuelan pregnant women: a case series
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Fhabián S, Carrión-Nessi, Daniela L, Mendoza-Millán, Óscar D, Omaña-Ávila, Sinibaldo R, Romero, Augusto, Moncada-Ortega, Mary, Lopez-Perez, Jaime R, Torres, Óscar, Noya-González, and David A, Forero-Peña
- Abstract
Malaria-endemic areas are not spared from the impact of coronavirus disease 2019 (COVID-19), leading to co-infection scenarios where overlapping symptoms impose serious diagnostic challenges. Current knowledge on Plasmodium spp. and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) co-infection in pregnant women remains limited, especially in Latin America, where Plasmodium vivax infection is highly prevalent.This is a case series of five pregnant women with P. vivax and SARS-CoV-2 co-infection hospitalized in two main malaria referral centers of the Capital District and Bolivar state, Venezuela between March 13, 2020 and December 31, 2021.Clinical and laboratory data from five pregnant women with a mean age of 22 years were analyzed; three of them were in the third trimester of pregnancy. Comorbidities included obesity in two cases, hypertension in one, and asthma in one. Three out of five patients had severe to critical COVID-19 disease. Dry cough, fever, chills, and headache were the most frequent symptoms reported. Laboratory analyses showed elevated aspartate/alanine aminotransferase and creatinine levels, thrombocytopenia, and severe anemia as the most relevant abnormalities. The mean period between symptom onset and a positive molecular test for SARS-CoV-2 infection or positive microscopy for Plasmodium spp. was 4.8 ± 2.5 days and 2.8 ± 1.6 days, respectively. The mean hospital stay was 5.4 ± 7 days. Three women recovered and were discharged from the hospital. Two women died, one from cerebral malaria and one from respiratory failure. Three adverse fetal outcomes were registered, two miscarriages and one stillbirth.This study documented a predominance of severe/critical COVID-19 disease and a high proportion of adverse maternal-fetal outcomes among pregnant women with malaria and COVID-19 co-infection. More comprehensive prospective cohort studies are warranted to explore the risk factors, management challenges, and clinical outcomes of pregnant women with this co-infection.
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- 2022
24. Predicting Mosquito-Borne Epidemics in Latin America
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Jaime R. Torres
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- 2022
25. Subungual hematomas after mRNA Covid-19 vaccine administration
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Jorge Murillo, Jaime R Torres, and Vanessa Leal
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Hematoma ,Nail Diseases ,COVID-19 Vaccines ,COVID-19 ,Humans ,General Medicine ,RNA, Messenger - Abstract
Large bilateral subungual haemorrhages and hematomas were observed in an adult woman after receiving the second dose of a mRNA COVID-19 vaccine. Improvement was achieved after a course of prednisone. Unusual, rare cutaneous adverse effects are likely to be increasingly noticed as the accelerated massive worldwide COVID-19 vaccination campaign intensifies.
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- 2022
26. Are rapid antigen SARS-Cov-2 tests effective for mass screening of travelers at airports? The Olympic experience
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Jaime R. Torres
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2019-20 coronavirus outbreak ,Point of entry ,Coronavirus disease 2019 (COVID-19) ,Antigen ,business.industry ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,Medicine ,General Medicine ,business ,Antigen testing ,Virology ,Mass screening - Abstract
Usefulness of mass screening of arriving travelers at airports through rapid antigenic tests to reduce the importation of SARS-Cov-2 into low incidence settings remains unproven. Recent successful Olympic experience indicates the need for additional strategies, including supervised quarantines, frequent retesting and close follow-up of positive individuals to achieve this goal.
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- 2021
27. Sequential Dengue and Coronavirus Disease 2019 (COVID-19): A Case of Viral Dr. Jekyll or Mr. Hyde?
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Jaime R. Torres
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Microbiology (medical) ,2019-20 coronavirus outbreak ,Coronavirus disease 2019 (COVID-19) ,business.industry ,SARS-CoV-2 ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,COVID-19 ,medicine.disease ,Virology ,Dengue fever ,Dengue ,Infectious Diseases ,medicine ,Humans ,business - Published
- 2021
28. Updated recommendations of the International Dengue Initiative expert group for CYD-TDV vaccine implementation in Latin America
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María L Avila-Aguero, Abiel Mascareñas, Luiza Helena Falleiros-Arlant, C. N Torres, Isabelle Delrieu, Bradford D. Gessner, J. M. Castellanos-Martinez, José Brea, Jaime R. Torres, and H. I.G. Giambernardino
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medicine.medical_specialty ,Civil society ,Internationality ,Latin Americans ,Cost-Benefit Analysis ,030231 tropical medicine ,Dengue Vaccines ,World Health Organization ,Scientific evidence ,Dengue fever ,Dengue ,03 medical and health sciences ,0302 clinical medicine ,Seroepidemiologic Studies ,Peru ,Epidemiology ,medicine ,Humans ,030212 general & internal medicine ,Dengue vaccine ,General Veterinary ,General Immunology and Microbiology ,Public health ,Health Plan Implementation ,Public Health, Environmental and Occupational Health ,Congresses as Topic ,medicine.disease ,Vaccination ,Latin America ,Infectious Diseases ,Family medicine ,Molecular Medicine ,Public Health ,Business - Abstract
Dengue disease represents a large and growing global threat to public health, causing a significant burden to health systems of endemic countries. For countries considering vaccination as part of their Integrated Management Strategy for Prevention and Control of Dengue, the World Health Organization currently recommends the first licensed dengue vaccine, CYD-TDV for: individuals aged 9 years or above from populations with high transmission rates, based on either seroprevalence criteria or pre-vaccination screening strategies, and for persons with confirmed prior exposure to infection in moderate to lower transmission settings. This paper describes the main conclusions of the Sixth Meeting of the International Dengue Initiative (IDI) held in June 2018, following release of a new product label by the manufacturer, updated WHO-SAGE recommendations, additional scientific evidence on vaccine performance, and reports of experiences by implementing countries. Considerations were made regarding the need for improving the quality of epidemiological and surveillance data in the region to help define the convenience of either of the two vaccination strategies recommended by WHO-SAGE. Extensive discussion was dedicated to the pros and cons of implementing either of such strategies in Latin America. Although, in general, a seroprevalence-based approach was preferred in high transmission settings, when cost-effectivity is favorable pre-vaccination screening is a convenient alternative. Cost-effectiveness evaluations can assist with the decisions by public health authorities of whether to introduce a vaccine. Where implemented, vaccine introduction should be part of a public health strategy that includes the participation of multiple sectors of society, incorporating input from scientific societies, ministries of heath, and civil society, while ensuring a robust communication program.
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- 2019
29. Molecular and epidemiologic characterization of the diphtheria outbreak in Venezuela
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Silvana Vielma, Maria Alejandra Rosas, Julio Castro, Lisbeth Aurenty, Daniel Eibach, Francis Bertuglia, María Graciela López, Omaira Andrade, Erick Hernández, Laura Herrera-León, Valeria Navas, Silvia Herrera-León, Ricardo Strauss, Jürgen May, Elizabeth Hernandez, Jaime R. Torres, Ana C Guillén, Neiris Lopez, Eva Lorenz, Ana Carvajal, José Gregorio Martínez, Tatiana Drummond, Trina Navas, Bernhard Nocht Institute for Tropical Medicine (Alemania), and Bernhard Nocht Institute for Tropical Medicine
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0301 basic medicine ,Adult ,Male ,Veterinary medicine ,Adolescent ,Science ,030106 microbiology ,Biology ,Disease cluster ,Microbiology ,Article ,Retrospective data ,Disease Outbreaks ,03 medical and health sciences ,Young Adult ,Case fatality rate ,medicine ,Humans ,Child ,Phylogeny ,Retrospective Studies ,Multidisciplinary ,Diphtheria ,Corynebacterium diphtheriae ,Health care ,Outbreak ,Middle Aged ,medicine.disease ,Venezuela ,030104 developmental biology ,Vaccination coverage ,Child, Preschool ,Multilocus sequence typing ,Medicine ,Infectious diseases ,Female ,Clinical record ,Multilocus Sequence Typing - Abstract
In 2016, Venezuela faced a large diphtheria outbreak that extended until 2019. Nasopharyngeal or oropharyngeal samples were prospectively collected from 51 suspected cases and retrospective data from 348 clinical records was retrieved from 14 hospitals between November 2017 and November 2018. Confirmed pathogenic Corynebactrium isolates were biotyped. Multilocus Sequence Typing (MLST) was performed followed by next-generation-based core genome-MLST and minimum spanning trees were generated. Subjects between 10 and 19 years of age were mostly affected (n = 95; 27.3%). Case fatality rates (CFR) were higher in males (19.4%), as compared to females (15.8%). The highest CFR (31.1%) was observed among those under 5, followed by the 40 to 49 age-group (25.0%). Nine samples corresponded to C. diphtheriae and 1 to C. ulcerans. Two Sequencing Types (ST), ST174 and ST697 (the latter not previously described) were identified among the eight C. diphtheriae isolates from Carabobo state. Cg-MLST revealed only one cluster also from Carabobo. The Whole Genome Sequencing analysis revealed that the outbreak seemed to be caused by different strains with C. diphtheriae and C. ulcerans coexisting. The reemergence and length of this outbreak suggest vaccination coverage problems and an inadequate control strategy. Open Access funding enabled and organized by Projekt DEAL. This work was supported by the Bernhard Nocht Institute for Tropical Medicine, Department of Infectious Disease Epidemiology budget not related with any particular grant. Sí
- Published
- 2021
30. Current regional consensus recommendations on infant vaccination of the Latin American pediatric infectious diseases society (SLIPE)
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Luiza Helena Falleiros-Arlant, Jaime R. Torres, Abiel Mascareñas, José Brea, Rolando Ulloa-Gutierrez, María L Avila-Aguero, and Eduardo López
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0301 basic medicine ,medicine.medical_specialty ,Latin Americans ,Immunology ,Immunization, Secondary ,03 medical and health sciences ,0302 clinical medicine ,Infant vaccination ,Vaccine-Preventable Diseases ,Drug Discovery ,Medicine ,Humans ,030212 general & internal medicine ,Vaccines, Combined ,book ,Immunization Schedule ,Pharmacology ,Vaccines ,business.industry ,Vaccination ,Infant, Newborn ,Infant ,030104 developmental biology ,Latin America ,Family medicine ,Pediatric Infectious Disease ,Molecular Medicine ,book.journal ,Vaccine-preventable diseases ,business - Abstract
The 1st Regional Experts on Infant Vaccination (REIV) meeting generated updated consensus recommendations to improve the control of various major vaccine preventable diseases (VPD) in Latin America.Workshops highlighted recent changes in immunization schedules within the region, experience of countries incorporating combined acellular pertussis vaccines schedules and parenteral inactivated polio vaccine (IPV). The need to definitively replace oral polio vaccine (OPV) by IPV, and potential benefits of introducing new combined vaccines, were extensively discussed.REIV strongly advised immediate adoption of either complete IPV schedules for all Latin America or schedules including at least two initial doses of IPV. Use of fractional doses of intradermally administered IPV (fIPV ID) was not recommended due to lower immunogenicity, lack of evidence on long-term protection, and technical difficulty to implement. Routine pertussis vaccination of pregnant women in addition to health workers of neonatology units and any previously unimmunized parent was encouraged. Administration of HBV vaccine to newborns within the first 24 hours of life, and then at 2, 4, and 6 months, and of a booster dose of conjugate Hib vaccine at age 12 through 15 months, was also recommended. Incorporation of combined vaccines (CV) was considered potentially advantageous.
- Published
- 2020
31. Investigating the utility of Google trends for Zika and Chikungunya surveillance in Venezuela
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Kaja Kristensen, Eva Lorenz, Jaime R. Torres, Julio Castro, Daniel Eibach, Ricardo Strauss, and Jürgen May
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medicine.medical_specialty ,Fever ,Urban Population ,viruses ,Internet search queries ,030231 tropical medicine ,Information Seeking Behavior ,Surveillance Methods ,Context (language use) ,Disease ,medicine.disease_cause ,Zika virus ,Dengue ,03 medical and health sciences ,0302 clinical medicine ,Zika ,Government Agencies ,Environmental health ,Epidemiology ,Medicine ,Humans ,Chikungunya ,Epidemics ,Disease burden ,030304 developmental biology ,0303 health sciences ,Internet ,biology ,business.industry ,Zika Virus Infection ,lcsh:Public aspects of medicine ,Public health ,Incidence ,Public Health, Environmental and Occupational Health ,virus diseases ,lcsh:RA1-1270 ,Zika Virus ,Dengue Virus ,biology.organism_classification ,Venezuela ,Surveillance systems ,Search Engine ,Population Surveillance ,Chikungunya Fever ,business ,Chikungunya virus ,Arboviruses ,Research Article - Abstract
Introduction Chikungunya and Zika Virus are vector-borne diseases responsible for a substantial disease burden in the Americas. Between 2013 and 2016, no cases of Chikungunya or Zika Virus were reported by the Venezuelan Ministry of Health. However, peaks of undiagnosed fever cases have been observed during the same period. In the context of scarce data, alternative surveillance methods are needed. Assuming that unusual peaks of acute fever cases correspond to the incidences of both diseases, this study aims to evaluate the use of Google Trends as an indicator of the epidemic behavior of Chikungunya and Zika. Methods Time-series cross-correlations of acute fever cases reported by the Venezuelan Ministry of Health and data on Google search queries related to Chikungunya and Zika were calculated. Results A temporal distinction has been made so that acute febrile cases occurring between 25th of June 2014 and 23rd of April 2015 were attributed to the Chikungunya virus, while cases occurring between 30th of April 2015 and 29th of April 2016 were ascribed to the Zika virus. The highest cross-correlations for each disease were shown at a lag of 0 (r = 0.784) for Chikungunya and at + 1 (r = 0.754) for Zika. Conclusion The strong positive correlation between Google search queries and official data on acute febrile cases suggests that this resource can be used as an indicator of endemic urban arboviruses activity. In the Venezuelan context, Internet search queries might help to overcome some of the gaps that exist in the national surveillance system.
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- 2020
32. Google dengue trends: An indicator of epidemic behavior. The Venezuelan Case
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Ralf Reintjes, Julio Castro, Ricardo A. Strauss, and Jaime R. Torres
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medicine.medical_specialty ,Databases, Factual ,media_common.quotation_subject ,030231 tropical medicine ,Developing country ,Health Informatics ,Clinical decision support system ,Dengue fever ,Dengue ,03 medical and health sciences ,0302 clinical medicine ,Public health surveillance ,Environmental health ,medicine ,Humans ,Public Health Surveillance ,030212 general & internal medicine ,Epidemics ,Simulation ,media_common ,Variables ,Warning system ,business.industry ,Incidence ,Public health ,Venezuela ,medicine.disease ,Search Engine ,The Internet ,business - Abstract
Dengue Fever is a neglected increasing public health thread. Developing countries are facing surveillance system problems like delay and data loss. Lately, the access and the availability of health-related information on the internet have changed what people seek on the web. In 2004 Google developed Google Dengue Trends (GDT) based on the number of search terms related with the disease in a determined time and place. The goal of this review is to evaluate the accuracy of GDT in comparison with traditional surveillance systems in Venezuela.Weekly epidemic data from GDT, Official Reported Cases (ORC) and Expected Cases (EC) according the Ministry of Health (MH) was obtained Monthly and yearly correlation between GDT and ORC from 2004 until 2014 was obtained. Linear regressions taking the reported cases as dependent variable were calculated.The overall Pearson correlation between GDT and ORC was r=0.87 (p0.001), while between ORC and EC according the Ministry of Health (MH) was r=0.33 (p0.001). After clustering data in epidemic and non-epidemic weeks in comparison with GDT correlation were r=0.86 (p0.001) and r=0.65 (p0.001) respectively. Important interannual variation of the epidemic was observed. The model shows a high accuracy in comparison with the EC, particularly when the incidence of the disease is higher.This early warning tool can be used as an indicator for other communicable diseases in order to apply effective and timely public health measures especially in the setting of weak surveillance systems.
- Published
- 2017
33. The 17th International Congress on Infectious Diseases workshop on developing infection prevention and control resources for low- and middle-income countries
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Shaheen Mehtar, Nadia Masroor, Revathi Gunturu, Alison Holmes, Miguel O'Ryan, Ziad Memish, Evelyn Wesangula, Fiona Macnab, Britta Lassmann, Sangeeta Sastry, Paul D. Brown, Rachel Kamau, Jaime R. Torres, Gonzalo Bearman, Fatma A. Amer, Frances Daily, André N.H. Bulabula, Didier Pittet, Rana A. Hajjeh, and Paras Kumar Pokharel
- Subjects
Cross Infection/epidemiology ,0301 basic medicine ,IMPACT ,Infection control ,medicine.disease_cause ,Disease Outbreaks ,DEVICE-ASSOCIATED MODULE ,0302 clinical medicine ,1108 Medical Microbiology ,Environmental protection ,Infection prevention ,Medicine ,030212 general & internal medicine ,ddc:616 ,Cross Infection ,Low- and middle-income countries ,General Medicine ,INTENSIVE-CARE UNITS ,Infectious Diseases ,International ,Health Resources ,MULTIDIMENSIONAL APPROACH ,Life Sciences & Biomedicine ,0605 Microbiology ,Microbiology (medical) ,Middle East respiratory syndrome coronavirus ,030106 microbiology ,Control (management) ,India ,Developing country ,Context (language use) ,Microbiology ,Article ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,Environmental health ,Humans ,lcsh:RC109-216 ,RATES ,Developing Countries ,Poverty ,Workshop ,ComputingMethodologies_COMPUTERGRAPHICS ,Infection Control ,Science & Technology ,VENTILATOR-ASSOCIATED PNEUMONIA ,Ebola virus ,business.industry ,Outbreak ,CONTROL STRATEGY ,CONTROL CONSORTIUM INICC ,business ,Delivery of Health Care - Abstract
Graphical abstract, Highlights • Hospital-acquired infections (HAIs) are associated with significant morbidity and mortality across the globe. • Resources outlining infection prevention and control (IPC) practices are in existence, but there are many barriers to IPC implementation in low- and middle-income countries (LMICs). • Further studies are required to evaluate simplified approaches adapted to the needs of LMICs in order to guide IPC in practice., Summary Hospital-acquired infections (HAIs) are a major concern to healthcare systems around the world. They are associated with significant morbidity and mortality, in addition to increased hospitalization costs. Recent outbreaks, including those caused by the Middle East respiratory syndrome coronavirus and Ebola virus, have highlighted the importance of infection control. Moreover, HAIs, especially those caused by multidrug-resistant Gram-negative rods, have become a top global priority. Although adequate approaches and guidelines have been in existence for many years and have often proven effective in some countries, the implementation of such approaches in low- and middle-income countries (LMICs) is often restricted due to limited resources and underdeveloped infrastructure. While evidence-based infection prevention and control (IPC) principles and practices are universal, studies are needed to evaluate simplified approaches that can be better adapted to LMIC needs, in order to guide IPC in practice. A group of experts from around the world attended a workshop held at the 17th International Congress on Infectious Diseases in Hyderabad, India in March 2016, to discuss the existing IPC practices in LMICs, and how best these can be improved within the local context.
- Published
- 2017
34. Long-term comparative pharmacovigilance of orally transmitted Chagas disease: first report
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Raiza Ruiz-Guevara, Giuseppa Quinci, Humberto Gutiérrez, Oscar Noya, John Ossenkopp, Zoraida Díaz-Bello, Laura Naranjo, Oscar Noya-Alarcon, Jaime R. Torres, José Antonio Suárez, Julio Castro, Belkisyolé Alarcón de Noya, and Cecilia Colmenares
- Subjects
Male ,0301 basic medicine ,Microbiology (medical) ,Chagas disease ,medicine.medical_specialty ,Trypanosoma cruzi ,030231 tropical medicine ,030106 microbiology ,Neutropenia ,Microbiology ,Pharmacovigilance ,03 medical and health sciences ,0302 clinical medicine ,Virology ,Internal medicine ,medicine ,Humans ,Chagas Disease ,Nifurtimox ,Adverse effect ,business.industry ,Common Terminology Criteria for Adverse Events ,medicine.disease ,Trypanocidal Agents ,Surgery ,Cross-Sectional Studies ,Infectious Diseases ,Nitroimidazoles ,Benznidazole ,Cohort ,Female ,business ,medicine.drug - Abstract
Two old drugs are the only choice against Trypanosoma cruzi and little is known about their secondary effects in the acute stage of oral-transmitted Chagas disease (ChD).A cross-sectional analytical surveillance study was conducted in a sizable cohort of patients seen during the largest acute foodborne ChD microepidemic registered so far. Individuals were treated with benznidazole (BNZ) or nifurtimox (NFX). 'Common Terminology Criteria for Adverse Events' was assessed to categorize side effects according to severity.Out of 176 treatments applied, 79% had one or more adverse effects, which predominated in adults (97.8%) as compared to children (75.5%). Risk of side effects with NFX was significantly higher than BNZ. Four adults and a child treated with NFX had severe side effects (pulmonary infarction, facial paralysis, neutropenia, blurred vision, bone marrow hypoplasia) warranting hospitalization, and drug suspension. Adverse effects frequently reported with NFX were abdominal pain, hyporexia, weight loss, headache, nausea and lymphocytosis, whereas skin rash, neurosensory effects, hyporexia, fatigue, pyrosis, abdominal pain and eosinophilia were observed with BNZ.Frequency and severity of side effects during treatment of acute oral infection by T. cruzi demand direct supervision and close follow-up, even in those asymptomatic, to prevent life-threatening situations.
- Published
- 2017
35. Epidemiological Characteristics of Dengue Disease in Latin America and in the Caribbean: A Systematic Review of the Literature
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Maricela Piña-Pozas, Tomás Agustín Orduna, Elsa Sarti, Daniela Vázquez-Vega, and Jaime R. Torres
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medicine.medical_specialty ,Caribbean island ,lcsh:Arctic medicine. Tropical medicine ,Latin Americans ,lcsh:RC955-962 ,Public health ,030231 tropical medicine ,Outbreak ,Review Article ,General Medicine ,Disease ,medicine.disease ,Microbiology ,Dengue fever ,03 medical and health sciences ,0302 clinical medicine ,Geography ,Environmental protection ,Environmental health ,Epidemiology ,medicine ,Parasitology ,030212 general & internal medicine ,Socioeconomic status - Abstract
Dengue, an important mosquito-borne virus transmitted mainly byAedes aegypti, is a major public health issue in Latin America and the Caribbean. National epidemiological surveillance systems, usually based on passive detection of symptomatic cases, while underestimating the true burden of dengue disease, can provide valuable insight into disease trends and excess reporting and potential outbreaks. We carried out a systematic review of the literature to characterize the recent epidemiology of dengue disease in Latin America and the English-speaking and Hispanic Caribbean Islands. We identified 530 articles, 60 of which met criteria for inclusion. In general, dengue seropositivity across the region was high and increased with age. All four virus serotypes were reported to circulate in the region. These observations varied considerably between and within countries and over time, potentially due to climatic factors (temperature, rainfall, and relative humidity) and their effect on mosquito densities and differences in socioeconomic factors. This review provides important insight into the major epidemiological characteristics of dengue in distinct regions of Latin America and the Caribbean, allowing gaps in current knowledge and future research needs to be identified.
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- 2017
36. Venezuela's migration crisis: a growing health threat to the region requiring immediate attention
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Jaime R. Torres and Julio Castro
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Economic growth ,Travel ,business.industry ,MEDLINE ,Medicine ,Humans ,Attention ,General Medicine ,business ,Venezuela ,Communicable Diseases - Published
- 2018
37. Congenital and perinatal complications of chikungunya fever: a Latin American experience
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José Brea del Castillo, Jorge Pleitez-Navarrete, Lourdes Dueñas, Luiza Helena Falleiros-Arlant, Jaime R. Torres, and Doris M. Salgado
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Male ,Pediatrics ,Complications ,medicine.disease_cause ,Disease Outbreaks ,Congenital ,0302 clinical medicine ,Pregnancy ,Case fatality rate ,Epidemiology ,Medicine ,Prospective Studies ,030212 general & internal medicine ,Chikungunya ,Pregnancy Complications, Infectious ,Incidence ,Incidence (epidemiology) ,Pregnancy Outcome ,Meningoencephalitis ,General Medicine ,Infectious Diseases ,Female ,Chikungunya virus ,Adult ,Microbiology (medical) ,medicine.medical_specialty ,Adolescent ,Genotype ,Pregnancy Trimester, Third ,030231 tropical medicine ,Lymphocytic pleocytosis ,Mothers ,Perinatal ,lcsh:Infectious and parasitic diseases ,Young Adult ,03 medical and health sciences ,Humans ,lcsh:RC109-216 ,business.industry ,Infant, Newborn ,Infant ,Outbreak ,medicine.disease ,Infectious Disease Transmission, Vertical ,Surgery ,Latin America ,Chikungunya Fever ,business - Abstract
Summary Background During the years 2014 and 2015, the Region of the Americas underwent a devastating epidemic of chikungunya virus (CHIKV) of the Asian genotype, resulting in millions of affected individuals. However, epidemiological and clinical information on this experience is scarce. Prior knowledge of congenital and neonatal illness caused by CHIKV is limited and almost exclusively based on data obtained from a single outbreak of the East/Central/South African (ECSA) genotype. The effect of chikungunya fever (CHIKF) on pregnancy outcomes and its consequences for infants born to infected mothers at the peak of the epidemic wave in Latin America are reviewed herein. Epidemiological and clinical data on maternal and neonatal infections were collected prospectively and analyzed. Methods One hundred sixty-nine symptomatic newborns with CHIKF seen at four large regional maternity hospitals in three different Central and South American countries were evaluated prospectively. The outcomes of pregnancies in symptomatic infected mothers at two of these clinical centers were also analyzed. Results The observed vertical transmission rate ranged between 27.7% and 48.29%. The incidence of congenital disease was unrelated to the use of cesarean section or natural delivery. The case fatality rate (CFR) at the only center that reported deaths was 5.3%. The most common clinical manifestations included fever, irritability, rash, hyperalgesia syndrome, diffuse limb edema, meningoencephalitis, and bullous dermatitis. Severe complications included meningoencephalitis, myocarditis, seizures, and acute respiratory failure. Leukocytosis with neutrophilia and normal or increased platelets was a common finding, and in those with signs of meningeal involvement, moderate lymphocytic pleocytosis with normal glucose and protein levels was typical. Conclusions This study presents the largest number of symptomatic neonates with CHIKF analyzed so far in any region and is the first involving infection with the Asian genotype of CHIKV. Although the clinical manifestations found were similar to those reported previously, the percentage of neurological complications was lower. The CFR was comparatively high. Chikungunya represented a substantial risk for neonates born to symptomatic parturients during the chikungunya outbreak in the Americas Region, with important clinical and public health implications.
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- 2016
38. Congenital Chagas’ disease transmission in the United States: Diagnosis in adulthood
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Carlos Torres-Viera, Jorge Murillo, Lina Bofill, Daniel Benhayon, Hector Bolivar, Jaime R. Torres, and Julio A. Urbina
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0301 basic medicine ,Chagas disease ,030231 tropical medicine ,030106 microbiology ,Case Report ,Infectious and parasitic diseases ,RC109-216 ,Disease ,Serology ,Congenital ,03 medical and health sciences ,0302 clinical medicine ,Pregnancy ,parasitic diseases ,medicine ,Transmission ,Trypanosoma cruzi ,biology ,Transmission (medicine) ,business.industry ,medicine.disease ,biology.organism_classification ,Infectious Diseases ,Immunology ,business - Abstract
Two brothers with congenitally-acquired Chagas’ disease (CD) diagnosed during adulthood are reported. The patients were born in the USA to a mother from Bolivia who on subsequent assessment was found to be serologically positive for Trypanosoma cruzi. Serologic screening of all pregnant women who migrated from countries with endemic CD is strongly recommended.
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- 2016
39. Genetic diversity of hepatitis B virus and hepatitis C virus in human immunodeficiency virus type 1-co-infected patients from Venezuela
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Flor H. Pujol, Marisol Devesa, Carmen L. Loureiro, Yesseima Rodríguez, Yoneira Sulbarán, Jaime R. Torres, Héctor R. Rangel, Rossana C. Jaspe, and Nahir Martinez
- Subjects
Adult ,Male ,Microbiology (medical) ,Hepatitis B virus ,Adolescent ,Genotype ,Hepatitis C virus ,Molecular Sequence Data ,Human immunodeficiency virus (HIV) ,HIV Infections ,Hepacivirus ,medicine.disease_cause ,Microbiology ,Therapy naive ,Young Adult ,Antigen ,Humans ,Medicine ,Genetic diversity ,Coinfection ,business.industry ,Transmission (medicine) ,Genetic Variation ,virus diseases ,General Medicine ,Middle Aged ,Hepatitis B ,Venezuela ,Hepatitis C ,Virology ,digestive system diseases ,Immunology ,HIV-1 ,Female ,business - Abstract
The aim of this study was to evaluate the prevalence and genetic diversity of hepatitis B virus (HBV) and hepatitis C virus (HCV) in human immunodeficiency virus type 1 (HIV-1)-co-infected Venezuelan patients. The prevalence of HBV and HCV markers of infection in HIV-1 patients was 14 % for anti-hepatitis B core antigen, 3 % for hepatitis B surface antigen and 0.7 % for anti-HCV, respectively. HBV prevalence was higher than HCV, as expected for a country where sexual intercourse, not intravenous drug use, is the main mode of HIV-1 transmission. The HCV genotype distribution in HIV-1-co-infected patients was similar to that obtained in HCV-mono-infected patients, but genotype 1a was more frequent in HIV-1-infected patients. The HBV genotype distribution exhibited differences between mono-infected and HIV-1-co-infected individuals. HBV F3 was the most common subgenotype in both groups, followed by F1b in HIV-1 co-infection and F2 in HBV mono-infection. In addition, genotype G (single infection) was found in an HIV-1-co-infected individual. A high prevalence of occult HBV infection was detected in HIV-1-co-infected naive patients (18 %), with F2 being the most common genotype (75 %). To the best of our knowledge, these results correspond to the first description of frequency and molecular characterization of HBV and HCV in HIV-1 Venezuelan patients.
- Published
- 2014
40. Microhematospermia in acute Zika virus infection
- Author
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Zoila Moros, Nahir Martinez, and Jaime R. Torres
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0301 basic medicine ,Microbiology (medical) ,03 medical and health sciences ,030104 developmental biology ,Infectious Diseases ,biology ,lcsh:RC109-216 ,General Medicine ,biology.organism_classification ,Virology ,Zika virus ,lcsh:Infectious and parasitic diseases - Published
- 2016
41. Google dengue trends: An indicator of epidemic behavior. The Venezuelan case
- Author
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M. Herrera, R. Strauss, Jaime R. Torres, Ralf Reintjes, J.M. Olivares, J.S. Castro, and G. Provenza
- Subjects
Microbiology (medical) ,030503 health policy & services ,General Medicine ,medicine.disease ,Virology ,Dengue fever ,03 medical and health sciences ,0302 clinical medicine ,Geography ,Infectious Diseases ,Environmental health ,medicine ,030212 general & internal medicine ,0305 other medical science - Published
- 2016
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42. Google trend tool as a predictor of Chikungunya and Zika epidemic in a enviroment with little epidemiological data, a Venezuelan case
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J. Oletta, J.S. Castro, Jaime R. Torres, and R. Strauss
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Microbiology (medical) ,medicine.medical_specialty ,030503 health policy & services ,General Medicine ,medicine.disease_cause ,Virology ,03 medical and health sciences ,0302 clinical medicine ,Geography ,Infectious Diseases ,Environmental health ,Epidemiology ,medicine ,030212 general & internal medicine ,Chikungunya ,0305 other medical science - Published
- 2016
- Full Text
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43. Absence of Primary Integrase Resistance Mutations in HIV Type 1-Infected Patients in Venezuela
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Cristina Gutiérrez, Flor H. Pujol, Héctor R. Rangel, Jaime R. Torres, Domingo Garzaro, John Ossenkop, Rona Fabbro, and Nahir Martinez
- Subjects
medicine.medical_treatment ,Molecular Sequence Data ,Immunology ,Integrase inhibitor ,HIV Infections ,HIV Integrase ,Drug resistance ,medicine.disease_cause ,Drug Resistance, Multiple, Viral ,Virology ,medicine ,Humans ,HIV Integrase Inhibitors ,Mutation ,Protease ,biology ,HIV Protease Inhibitors ,Venezuela ,Resistance mutation ,Reverse transcriptase ,Integrase ,Infectious Diseases ,DNA, Viral ,HIV-1 ,biology.protein ,Reverse Transcriptase Inhibitors ,Viral disease - Abstract
The preexistence of mutations to integrase inhibitors in HIV-1-infected Venezuelan patients was evaluated. The integrase region of the HIV-1 genome was amplified by nested-PCR and sequenced in 57 isolates from both naive (n = 24) and treated patients who received protease and/or reverse transcriptase inhibitors (PI and RTI, n = 33), but were never exposed to integrase inhibitors. Only one primary integrase resistance mutation, not conferring drug resistance by itself, was found among these patients, although several minor viral mutations, equally distributed among naive and PI- and RTI-treated patients, were also found. In the limited number of samples, no relation was found among the presence of resistance mutations to PI or RTI and the presence of minor mutations to integrase. The absence of resistance to integrase inhibitors may be related to the recent introduction of these drugs in our country. The availability of in-house assays allows for a more comprehensive surveillance of drug resistance to integrase inhibitors in Venezuela.
- Published
- 2010
44. Large Urban Outbreak of Orally Acquired Acute Chagas Disease at a School in Caracas, Venezuela
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Cecilia Colmenares, Luciano Mauriello, Jaime R. Torres, L Rivas, Ivan Mendoza, Belkisyolé Alarcón de Noya, Teresa Abate, Julio Castro, Raiza Ruiz-Guevara, Harry Acquatella, Zoraida Díaz-Bello, José Antonio Suárez, Manuel Paiva, Oscar Noya, Laura Naranjo, Juan Marques, and Reinaldo Zavala-Jaspe
- Subjects
Male ,Chagas disease ,medicine.medical_specialty ,Adolescent ,Urban Population ,Trypanosoma cruzi ,Prevalence ,Parasitemia ,Polymerase Chain Reaction ,Disease Outbreaks ,Beverages ,Foodborne Diseases ,Electrocardiography ,Young Adult ,Risk Factors ,Internal medicine ,Epidemiology ,medicine ,Humans ,Immunology and Allergy ,Chagas Disease ,Child ,Psidium ,Schools ,Transmission (medicine) ,business.industry ,Age Factors ,Outbreak ,Hemagglutination Tests ,Venezuela ,medicine.disease ,Vaccination ,Logistic Models ,Infectious Diseases ,Case-Control Studies ,Immunology ,Female ,business ,Trypanosomiasis - Abstract
Background Trypanosoma cruzi oral transmission is possible through food contamination by vector's feces. Little is known about the epidemiology and clinical features of microepidemics of orally acquired acute Chagas disease (CD). Methods A case-control, cohort-nested, epidemiological study was conducted during an outbreak of acute CD that affected a school community. Structured interviews were designed to identify symptoms and sources of infection. Electrocardiograms were obtained for all patients. Specific serum antibodies were assessed by immunoenzimatic and indirect hemagglutination tests. In some cases, parasitemia was tested directly or by culture, animal inoculation, and/or a polymerase chain reaction technique. Results Infection was confirmed in 103 of 1000 exposed individuals. Of those infected, 75% were symptomatic, 20.3% required hospitalization, 59% showed ECG abnormalities, parasitemia was documented in 44, and 1 child died. Clinical features differed from those seen in vectorial transmission. The infection rate was significantly higher among younger children. An epidemiological investigation incriminated contaminated fresh guava juice as the sole source of infection. Conclusions This outbreak was unique, because it affected a large, urban, predominantly young, middle-class, otherwise healthy population and resulted in an unprecedented public health emergency. Rapid diagnosis and treatment avoided higher lethality. Food-borne transmission of T. cruzi may occur more often than is currently recognized.
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- 2010
45. Prevalence of antiretroviral drug resistance among treatment-naive and treated HIV-infected patients in Venezuela
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Cristina Gutiérrez, Domingo Garzaro, Jaime R. Torres, Héctor R. Rangel, Nahir Martinez, Julio Castro, Flor Helene Pujol, Laura Naranjo, John Ossenkopp, and José Antonio Suárez
- Subjects
Adult ,Male ,genotypic resistance ,Microbiology (medical) ,lcsh:Arctic medicine. Tropical medicine ,Anti-HIV Agents ,lcsh:RC955-962 ,medicine.medical_treatment ,lcsh:QR1-502 ,diagnostic ,HIV Infections ,Antiretroviral drug ,Drug resistance ,lcsh:Microbiology ,Cohort Studies ,Therapy naive ,Pharmacotherapy ,Antiretroviral Therapy, Highly Active ,Drug Resistance, Viral ,Prevalence ,medicine ,Humans ,Hiv infected patients ,Protease ,Reverse Transcriptase Polymerase Chain Reaction ,business.industry ,HIV ,Venezuela ,Virology ,Mutation ,Immunology ,HIV-1 ,Genotypic resistance ,RNA, Viral ,Female ,business ,Cohort study - Abstract
An in-house, low-cost method was developed to determine the genotypic resistance of immunodeficiency virus type 1 (HIV-1) isolates. All 179 Venezuelan isolates analysed belonged to subtype B. Primary drug resistance mutations were found in 11% of 63 treatment-naïve patients. The prevalence of resistance in isolates from 116 HIV-positive patients under antiretroviral treatment was 47% to protease inhibitors, 65% to nucleoside inhibitors and 38% to non-nucleoside inhibitors, respectively. Around 50% of patients in the study harboured viruses with highly reduced susceptibility to the three classical types of drugs after only five years from their initial diagnoses.
- Published
- 2009
46. HIV Diversity in Venezuela: Predominance of HIV Type 1 Subtype B and Genomic Characterization of Non-B Variants
- Author
-
Luzmary Vásquez, Genni Guillen, Cristina Gutiérrez, Domingo Garzaro, Flor H. Pujol, Jaime R. Torres, and Héctor R. Rangel
- Subjects
Polymorphism, Genetic ,Genotype ,Sequence analysis ,Immunology ,Sequence Homology ,virus diseases ,HIV Infections ,Sequence Analysis, DNA ,Biology ,Venezuela ,biology.organism_classification ,Genetic analysis ,Virology ,Virus ,Infectious Diseases ,Polymorphism (computer science) ,Phylogenetics ,Lentivirus ,HIV-1 ,Cluster Analysis ,Humans ,Gene ,Phylogeny - Abstract
The aim of this study was the analysis of human immunodeficiency virus (HIV) diversity in Venezuela, and the characterization of variants other than subtype B. A total of 425 HIV isolates, collected between 2003 and 2008, were analyzed. The sequence of at least one genomic region (Pol, Env, Vif, or Nef ) was available for all of them and at least two genomic regions were analyzed in 46% of them. From the 425 HIV isolates analyzed, 421 (99.1%) were classified as HIV-1 subtype B. The four non-subtype B isolates correspond to one subtype C, one recombinant AG, and two HIV-2 isolates. This study shows that HIV-1 subtype B is still highly predominant in Venezuela. Whereas some sporadic cases of other HIV types can be found, they do not seem to have disseminated to the present.
- Published
- 2009
47. Non-immune thrombocytopenia responsive to antiretroviral therapy and HIV-2 infection
- Author
-
Flor H. Pujol, Jörg Schüpbach, Jaime R. Torres, Maria A. Torres-Viera, and Héctor R. Rangel
- Subjects
Family Health ,Male ,Microbiology (medical) ,Lymphoma ,Anti-HIV Agents ,business.industry ,Human immunodeficiency virus (HIV) ,HIV Infections ,Venezuela ,medicine.disease_cause ,medicine.disease ,Thrombocytopenia ,Antiretroviral therapy ,Virology ,Immune thrombocytopenia ,Infectious Diseases ,HIV-2 ,Immunology ,Humans ,Medicine ,Heterosexuality ,business ,Aged - Abstract
HIV-2 infection was documented for the first time in Venezuela, in a heterosexual couple. Two identical subtype A viral strains exhibiting multiple resistance mutations to antiretroviral drugs were identified. One of the patients suffered from progressive non-immune thrombocytopenia and extranodal NK/T-cell type lymphoma, an association not previously described for HIV-2. His hematological condition promptly improved after onset of an effective antiretroviral therapy.
- Published
- 2007
48. Epidemiology and Disease Burden of Pediatric Dengue in Venezuela
- Author
-
Jaime R, Torres, Luís, Echezuría, Mariano, Fernández, and Alejandro, Rísquez
- Subjects
Dengue ,Cost of Illness ,Child, Preschool ,Incidence ,Humans ,Infant ,Severe Dengue ,Dengue Virus ,Child ,Venezuela ,Disease Outbreaks ,Retrospective Studies - Abstract
Dengue is a mosquito-borne viral disease that has evolved from a sporadic infection to a major public health problem in the Americas, Southeast Asia and the western Pacific, and Africa. Its incidence has increased 30-fold over the past 50 years, and although the true disease burden is not well known, the annual incidence in some areas of the Americas may reach 5%-10% of all children when underreporting is considered. We recently analyzed the disease burden of dengue in Venezuela, and we found an overall decline in case numbers and mortality over the period of 1950-2011. However, there were increases in case number and mortality during epidemic years, especially among children. In this report, we focus on the most recent period of data, from 2000 to 2011, comparing pediatric and adult case numbers and mortality.
- Published
- 2015
49. Nasal Skin Necrosis: An Unexpected New Finding in Severe Chikungunya Fever
- Author
-
Víctor Saravia, Joanne Arvelaez, Julio Castro, Jaime R. Torres, and Leopoldo G. Córdova
- Subjects
Microbiology (medical) ,Adult ,Pathology ,medicine.medical_specialty ,Necrosis ,030231 tropical medicine ,Nasal necrosis ,Disease ,Nose ,Chikungunya fever ,Skin Diseases ,03 medical and health sciences ,0302 clinical medicine ,Fatal Outcome ,Nose Diseases ,medicine ,Humans ,030212 general & internal medicine ,Nose diseases ,Aged ,business.industry ,virus diseases ,Middle Aged ,medicine.disease ,Venezuela ,Infectious Diseases ,medicine.anatomical_structure ,Shock (circulatory) ,Chikungunya Fever ,medicine.symptom ,Multiple organ dysfunction syndrome ,business - Abstract
Three adult Venezuelan patients with virologically confirmed Chikungunya fever, who developed extensive acute nasal skin necrosis early in the course of a life-threatening illness characterized by shock and multiple organ dysfunction syndrome, are discussed. One patient survived and fully recovered. Nasal necrosis has not previously been associated with the disease.
- Published
- 2015
50. Cysticercosis Disease Burden in Latin America
- Author
-
Jaime R. Torres
- Subjects
Latin Americans ,Sanitation ,business.industry ,Neurocysticercosis ,Tropical disease ,Cysticercosis ,medicine.disease ,medicine.drug_formulation_ingredient ,Environmental health ,parasitic diseases ,Taenia solium ,medicine ,Taeniasis ,business ,Disease burden - Abstract
Cysticercosis is caused by infection with the larval form (or cysticercus) of the tapeworm Taenia solium. The most important clinical manifestations are caused by cysts in invading the central nervous system known as neurocysticercosis, which is associated with significant morbidity and disability in Latin America. Taeniasis and cysticercosis occur globally, with the highest rates in areas of Latin America, Asia, and sub-Saharan Africa associated with poor sanitation and free-ranging pigs with access to human feces. Control efforts in Latin America require an integration of both medical treatment of cases of taeniasis to prevent further transmission and of neurocysticercosis to decrease the burden of disease with antiparasitic drugs, steroids, and anticonvulsant therapy. Further efforts targeting interventions to improve health education of communities living in highly endemic settings combined with sanitation and poverty alleviation initiatives in Latin America may prove to have the highest impact to decrease the substantial morbidity and long-term neurologic consequences associated with this neglected tropical disease.
- Published
- 2015
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