miércoles, 29 de octubre de 2014

COMMUNITY BASED WORK + LETTER OF THE CHAIRMAN DR DANIEL HERNANDEZ


A group of amazing people has been in northern Argentina in the province of JUJUY the last weekend. During 3 days these colleagues visited three small towns and attended a total number of 950 patients. 

Link to the news: 
http://www.eltribuno.info/atencion-chagasicos-n458064

The group is under the leading advice and field work of the Cardiology specialists: Dr. Paul Flores, Dr. Guillermo Schmitt, Dr. Miguel Amor and Dr. Daniel O. Hernandez, Head of department in Internal Medicine in the Nordeast National University's Medical School. 

This initiative is reconized by the Argentinian Federation of Cardiology. 
http://www.fac.org.ar/index.php


The work i is focused not only in assistance to the people and medical studies but also on talks to the community for prevention.



It's not possible for many people in these rural areas to displace by themselves to the hospital. The Chagas Initiative in the Americas tries to acquire means and logistics to reach this people and to bring healthcare for fighting a disease that have a big burden in the quality of life. It shortens life expectancy and limits the capacity to work and the productivity of whole communities which already are in low socioeconomic status conditions. 

We come to the people


Thanks a lot for the support to all the donors and collaborators to this initiative. Our accomplishment could not be possible without your help.



 LETTER TO COLLEAGUES AND PUBLIC:  


My name is Dr. Daniel O. Hernandez.

I’ve got my degree in medicine in December 1995, at the Faculty of Medicine of the Nordeast National University UNNE.

I made the residence program in Cardiology 1997, at the Department of Cardiology, General San Martin Teaching Hospital in Corrientes, Argentina. Since June 1 of that year until May 31, 2001, I was Chief Resident, and afterwards Instructor of residence, through May 2002.

Since 2000, I am a Professor of the Faculty of Medicine UNNE.
2000-2003: Chairman of Internal Medicine Department at the Nordeast National University.
2003 - 2012: Head of department of the VI Catedra of Internal Medicine. 

Member of the Society of Cardiology of Corrientes, Argentinian Society of Cardiology, and currently Vice President Of the Chagas Committee in the Argentinian  Federation of Cardiology


In Chagas research, we got special Mentions and Awards:
With a group of doctors, nurses and students of the Nordeast School of Medicine, we obtained in 2010, two special mentions in the Argentine Congress of Cardiology
In 2011: the Scientific Committee of the Argentine Congress of Cardiology gave 1st prize On Best Basic Research
In 2012: the South American Congress of Cardiology in the City of Asuncion Paraguay, The scientific Committee gave the prize as the presentation in the South American Congress of Cardiology.

We have already attended to 2,300 patients in 15 villages of Interior the province of Chaco, also in  two Locations in the provinces of Formosa and 3 villages in the province of Santiago del Estero in the Northern region of Argentina.

At present, in the Faculty of Medicine in the city of Corrientes, northern Argentina, our Clinic runs a medical consult for Patients with Chagas-Mazza disease,  and we receive patients from throughout the province of Corrientes, Formosa, and even North of the province of Santa Fe. We have already attended  more than 300 patients in two years since we opened.


We have began  a Research protocol in our Chagas Disease Commitee:
This study protocol consist of

-IDENTIFICATION OF CLINICAL PROGNOSTIC MARKERS AND ANTIBODIES IN CHAGAS DISEASE
-ELECTROCARDIOGRAPHIC AND ECHOCARDIOGRAPHIC MARKERS
-STUDY OF ANTIMUSCARINIC ANTIBODIES IN PATIENTS WITH CRONIC CHAGAS DISEASE IN RURAL AND URBAN LOCATIONS OF NORTHERN  ARGENTINA.
This study is being carried out with a great deal of sacrifice, with a low budget. We use our own electrocardiography machines and we apport our personal echonomical resources to afford this initiative.

We have already included 1100 patients with Chagas disease to our study,  from 7 locations in the Provences of Jujuy and Formosa. Everything was done with  our limited resources:
- only  7 Holter machines
- 2 echocardiography machines (brought by two colleagues, specialists in cardiology from the city of Buenos Aires -Capitol of the country- that come to our expeditions in the north of Argentina)
-and 5 electrocardiography machines.


Now at this point we decided to start making Holter registers (24 hours electrocardiograms) to all patients who require it. In order to do that, we have to move so many miles to come to the remote and abandoned communities in rural areas of Argentina and to Stay several days doing the recordig and after that return to our homes.

All entities, corporations, hospitals, municipalities, counties and colleagues who are willing and want to participate by any means with our initiative shall be welcome.

Those who are able and willing to donate materials or economic founding for the realization of this protocol for the care of patients who have virtually no social security coverage and can not afford an elecrocardogram, Holter or an echocardiography, will receive the best of our gratefullness, and we are commited to report on the overviews of the results of our work.

All cardiologists, biochemists, general practitioners and medical students receive no charge or any remuneration for this study.

thank you very much for your support:

Dr Daniel Osvaldo Hernandez
H. D. Internal Medicine Education Department
Nordeast National University School of Medicine
 drdanhernandez@hotmail.com

Mariano Moreno 1240

Corrientes - República Argentina - CP: 3400
 
Teléfonos: (54) 379-4423155/4422290

Fax: (54) 379-4425508
 
Correo: info@med.unne.edu.ar







miércoles, 8 de octubre de 2014

A NEW VISIT TO JUJUY PROVINCE IN THE NORTH-WESTERN REGION OF ARGENTINA

Today 08th october 2014 the crew of the North East National University (UNNE) is traveling to The north western province of Jujuy, one of the many provinces affected by this endemic disease.

This time the group of doctor and medicine students will visit outpatients in the villages of Perico, Rodeito, San Pedro and Tilcara.

Thank you to all the colleagues that have engaged in this incursion and just let us know if you are interested in participating as a colleague in the group of physicians that take action in this initiative.

More information:

NEWPAPER'S LINK

All the activities will take place between the 09 and 11th october.

Next post will include a report on the results.

Greetings to all the readers of our blog, please spread the message world around.

domingo, 5 de octubre de 2014

LETTER TO THE CHAGAS INITIATIVE FROM OUR COLLEAGUE IN PARAGUAY (version en español al final de la version en inglés)

                       His name is Elías Menacho Eguez and he works as a doctor in the public sector in Asuncion, Capitol of Paraguay. He is an integrant of our Chagas Initiative. Elías did his Residency program in the Hospital de Clinicas General San Martin in Buenos Aires, and returned to his country, where he daily struggles to help patients affected of Chagas Disease. 


                              CHAGAS DISEASE: HISTORY AND PRESENT

As mentioned by the World Health Organization ( WHO ):  ”Chagas disease represents a serious public health problem considering their size, significance, impact and vulnerability".

Carlos Ribeiro Justiniano das Chagas (1879-1934) Brazilian sanitarian doctor discovered  the disease (1909) which was named after him. Today, one hundred years later, Chagas disease remains a ”hidden, ignored disease”, included as one of 17 neglected tropical diseases by the World Health Organization (WHO), because since the sixties no new drugs were developed to treat the condition, which is paradoxically the most endemic in Latin America,  from Mexico to Patagonia, where the wild and domestic cycles are mixed. This disease, caused by the parasite Trypanosoma cruzi, which is transmitted to the body through the bite of the "kissing bug", a bug present in homes, farms, stables and other local farm in impoverished areas.

                                             Dr. Carlos Chagas in his laboratory

                                                           Salvador Mazza Agentinian investigator, 1926

Probably in cause of being a disease that has high correlation to the low socio - economical status of large segments of Latin America is why it is not considered as an important matter of research, by the large companies producing medicines. By the same token the local governments do not make the necessary and sustained efforts to eradicate it.

It is therefore no wonder that more than 1 century since its discovery, we have not yet found any vaccine or a more effective treatment. I must admit that this does not only depend on medicine, which after all is just a science; it also depends on the interest of governments and companies that investigate for new medical products.

 Because of all these  problems related to the eradication of the disease it is important not to call it a ”disease of poverty”, but rather consider it as a social disease.

In the absence of technical resources, or new drugs,  it only remains to carry out prevention, and at the same time  governments need to take action by building safe housing, pest control, sanitation, as well as  implementation of social programs that help this population sector  solving their complex economic and sociological problems.


My country, Paraguay, is no stranger to this problem, according to the Paraguayan National Chagas Program, an estimated 165,000 people are infected with Chagas, however not everyone knows that they are infected; which implies that it is a prevalent disease and is an important health problem in our country:

http://www.ip.gov.py/index.php/noticias-destacadas/item/5435-en-paraguay-unas-165-000-personas-padecen-de-chagas 


I consider commendable the start of production of benznidazole in Argentina, which was announced by The Mundo Sano Foundation and the Argentinian Ministry of Health during an event in Buenos Aires. This will allow those infected to access treatment, something that until recently was not possible, because the pharmaceutical companies had stopped the production.

This disease affects us all, the public sector, the private sector and community at large, hence the need for common efforts to eradicate the disease completely and healing those infected (or at least mitigate the effects).
I hope this initiative will be extened, not only to my country, but also throughout Latin America, because no one is safe from this evil.

With best regards to all colleagues and donors of The Chagas Iniciative:


Dr. Elias Armando Menacho Egúez
Asunción, Paraguay

Reg. Prof. MSP 6056

Acerca del Mal de Chagas

Tal como la OMS menciona: la enfermedad de Chagas representa un serio problema de salud pública al considerar su magnitud, trascendencia, impacto y difícil vulnerabilidad.

Carlos Ribeiro Justiniano das Chagas (1879-1934) médico sanitarista brasileño, descubrió una enfermedad (1909) que fue bautizada con su nombre. Hoy, cien años después, el Chagas sigue siendo un mal escondido, incluida como una de las 17 enfermedades tropicales olvidadas por la Organización Mundial de la Salud (OMS), debido a que desde la década de los sesenta que no se desarrollaban nuevos fármacos para tratarla, una enfermedad olvidada que paradójicamente es la principal endemia en Latino América, desde México hasta la Patagonia, donde se mezclan los ciclos selvático y doméstico, de este mal, provocado por el parásito Trypanosoma cruzi que es transmitido al organismo por la picadura de la "vinchuca", un insecto presente en casas, granjas, establos y otros locales de labranza, en zonas empobrecidas.

Probablemente por ser una enfermedad que tiene alta relación con la situación socio – económica de amplios sectores de Latinoamérica para su desarrollo, por la pobreza existente, es que es dejada de lado para su investigación, por las grandes empresas productoras de medicina y también por los gobernantes de turno, quienes no realizan los esfuerzos necesarios y sostenidos para erradicarla.

Es así, que no me sorprende que, en más de 1 siglo desde su descubrimiento, no hayamos encontrado aun alguna vacuna o un tratamiento mucho más eficaz que el actual, pero debo reconocer que eso no depende solo de la medicina, que al fin y al cabo es una ciencia y como tal, no es magia; depende del interés de los gobiernos y empresas investigadoras de productos medicinales, la creación de estas.
Debido a todos estos inconvenientes relacionados con la erradicación de esta enfermedad se ha señalado la necesidad de no llamarla enfermedad de la pobreza, sino mas bien considerarla como una enfermedad social, pues ante la carencia de recursos sean estos de tipo nuevas drogas o técnicos, solo queda por realizar tareas de prevención, y para la misma es necesario la intervención de los gobiernos, para construcción de viviendas seguras, tareas de fumigaciones, saneamiento ambiental, etc., así como también la implementación de programas sociales que ayuden a este sector poblacional a la resolución de sus complejos problemas económicos y sociológicos.

Mi país, Paraguay, no es ajeno a esta problemática, según datos del Programa Nacional de Chagas, se estima que existen 165.000 personas infectadas con Chagas, sin embargo no todos saben que padece la misma; lo que implica que es una enfermedad prevalente y es un problema de salud relevante en nuestro país. http://www.ip.gov.py/index.php/noticias-destacadas/item/5435-en-paraguay-unas-165-000-personas-padecen-de-chagas

Considero loable el comienzo de la producción de benznidazol en Argentina, que fue anunciado por Fundación Mundo Sano junto al Ministerio de Salud de la Nación durante un evento en Buenos Aires. Pues esto hace posible que aquellos infectados accedan a un tratamiento, el mismo que hasta hace poco tiempo no era posible realizarlo, pues las empresas farmacéuticas dejaron de elaborarla.

Esta enfermedad nos incumbe a todos, sector público, sector privado y comunidad en general, de ahí la necesidad de aunar esfuerzos a fin de conseguir su total erradicación y en aquellos infectados su curación o por lo menos la mitigación de los efectos de la enfermedad.
Deseo que esta iniciativa de ustedes queridos colegas, tenga su reproducción, no solo en mi país, sino en toda Latinoamérica, pues nadie se encuentra a salvo de este mal.
Éxitos.


Dr. Elias Aramndo Menacho Egúez
Paraguay
Reg. Prof. MSP 6056