Walter Mario Caceres Leturia
I am a doctor, specialist in Infectious and Tropical Diseases and in Occupational Medicine and Environment.
I work in the Center of Occupational Health of the National Institute of Health of Lima. Peru
Location Lima. Peru.
Activity
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Walter Mario Caceres Leturia made a comment
With regard to cancer that is multicausal, the epidemiological information over time is to know the latency period, for example, cervical cancer has a latency of more than 10 years, we can prevent it with Pap tests, detecting the start of malignant cells in the cervix. uterus and treat it. With regard to the place, if it is relevant in the work activity that...
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Walter Mario Caceres Leturia made a comment
Incidence is the indicator that should be applied to acute diseases that have a short period of illness, such as the case of cancer, which has a high mortality rate in a short period. Therefore, the new cases measure the magnitude of the disease. And the prevalence for long-term or chronic diseases where we can easily assess the cases with the disease.
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The COVID 19 pandemic, in Peru the airport has been closed, we are in quarantine for 15 days, many companies have been closed and we have 7000 positive cases and 180 have died.
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COVID 19 disease appears to have a low lethality of 2%, and in a group of older adults, with co-morbidities, diabetes, hypertension, in chronic respiratory diseases. In Peru, we have pulmonary tuberculosis and the impact it causes on these patients is unknown.
We also have problems with malnutrition, anemia in a population of children, it is known that the... -
Walter Mario Caceres Leturia made a comment
I am an infectologist and work in Lima, Peru. There is presence of the coronavirus COVID 19 in my country, and I am interested in learning and exchanging experiences.
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Walter Mario Caceres Leturia made a comment
I am an infectious medicine doctor, in Lima, Peru we are already with a population with the disease of the Coronavirus COVID 19, it is an opportunity to learn about this new disease in the world and exchange experiences.
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Walter Mario Caceres Leturia made a comment
We are with a new disease caused by a new coronavirus (COVID-19 in the world, this course information will allow us to learn aspects of the disease to apply preventive and treatment measures. Thank you
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I believe that, if you can do research studies where the family participates, as in the case of infectious or genetic diseases, but these research studies must comply with all ethical requirements in human research.
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Walter Mario Caceres Leturia made a comment
Walter Mario Caceres Leturia
19 NOV
The experiments in humans carried out by the Nazis, has all our disapproval, but we obtained results or explained many advances in Medicine that was incorporated into the German Academy (School of Medicine as new knowledge), for example the use of the sulfonamide antibiotic, campaign against tobacco that produces cancer,... -
Walter Mario Caceres Leturia made a comment
My planned research is of "tuberculosis in health personnel in Peru", it is a public health problem, and features risk factors to allow intervention and take preventive measures, obtaining information is from the database of the tuberculosis program of the Ministry of Health, where the diagnosis is obtained from smear-positive, a card is prepared to obtain the...
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In Peru, there is a Law on Investigations in Humans, the National Institute of Health is the body that authorizes clinical trials and observational studies, with international standards, also within its functions gives accreditation to the Ethics Committees of the different institutions of the country.
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Research in children as opposed to adults requires more attention that must be focused on preventing and reducing research damage and ensuring adequate protection of children and young people. Children require more support compared to adults, that is, more time to explain the study or interview or when performing any clinical procedure, they must understand...
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Walter Mario Caceres Leturia made a comment
The vulnerable population can participate in a research study; however, they need special protection. The informed consent process, carried out with special attention to vulnerable people, promotes respect for people. Health conditions that are required reslice in this population as children, or improve their health in case of indigenous population etc ..
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Walter Mario Caceres Leturia made a comment
My model of informed consent is in the link...
https://padlet.com/dlt/RESEARCHETHICS2_12_Run1 -
The investigators had the responsibility to inform (informed consent) that the study consisted in making tests to see if they had syphilis, and should be treated for penicillin, also report that they could be infected to see study syphilis disease, the decision was voluntary , but that they would be monitored to indicate the treatment and not to cause damage...
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Sandra would be giving a payment as compensation for the participation anyway it lends to the need for payment to participate. Additional expenses could include the participant's trip to the research site, or having to buy lunch if they are at a research site all day. The ethical aspect is reasonable an economic amount as a recruitment to the study, not as a...
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In research with people the ethical aspect must be given through informed consent is to participate by own decision and having knowledge of how to participate (giving samples, taking medicines etc.), what benefit can be obtained (could be economic) , the damage can occur, you can make the decision to leave the investigation at any time
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The Milgram experiment is undermining the right of study subject autonomy to decide whether to participate prior knowledge of the experiment, is being coerced in its decision according to the experiment, does not assess the impact of the subject to the test subject's reaction, etc. therefore, its accomplishment is not justified ethically neither before nor at...
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I believe that the principles of Nuremberg and the Declaration of Helsinki, in the experimentation of Humans, covers a large part of the rights of the person or subjects participating in an experiment such as voluntary decision (informed consent), not causing harm, in the face of any damage suspend research (security), protection of vulnerable subjects (native...
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Walter Mario Caceres Leturia made a comment
The experiments in humans carried out by the Nazis, has all our disapproval, but we obtained results or explained many advances in Medicine that was incorporated into the German Academy (School of Medicine as new knowledge), for example the use of the sulfonamide antibiotic, campaign against tobacco that produces cancer, study of genetics in twins, hypothermia...
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Walter Mario Caceres Leturia made a comment
In Peru, my institution conducts research in jungle communities (Amazonia, Loreto), are vulnerable communities due to contamination of oil spills, heavy lead metals, arsenic cadmium, etc., there is difficulty due to informed consent, communication problem, etc.
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Walter Mario Caceres Leturia made a comment
My name is Walter Caceres, I am a doctor and specialist in Occupational Health, I work in the National Institute of Health in Peru and its function is to carry out research in public health, in my case about occupational health, it is of great interest to know the ethical aspects when performs research on human beings, mainly if you have vulnerable populations.
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Walter Mario Caceres Leturia made a comment
The Q2 as an important cause of the antimicrobial resistance and Q4 non-compliance with the recommendations of the use of antimicrobials. In Q2 the factors that generate the resistance are identified and where action must be taken, and in Q4, the measures and recommendations of the Intrahospital Infections Committees by the health personnel are obviously not met.
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Walter Mario Caceres Leturia made a comment
In Peru, antimicrobial resistance has forced the MINSA (2006) to take measures through the Committee of intrahospital infections. The National Health Institute has been designated to monitor antimicrobial resistance and collect monthly information from hospitals. In the Hospitals there have been Regulations for the use of appropriate antimicrobials in patients...
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Walter Mario Caceres Leturia made a comment
.1. The deficiencies observed in the hospitalization room are:
- Lack of Intrahospital Infection Control Protocols
inadequate prescription of antibiotics
- Non-compliance with hand hygiene practices
- No hand washing by all staff is responsible for patient care
- Dependent aseptic technique
2. Main drivers for infection
- Poor initial clinical evaluation
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Walter Mario Caceres Leturia made a comment
The glossary is necessary to handle the same concepts for topics related to antimicrobial resistance.
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Walter Mario Caceres Leturia made a comment
The knowledge that will be shared will be very useful in updating and practicing in our work.
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Walter Mario Caceres Leturia made a comment
I am a doctor, specialist in infectious and tropical diseases, of Lima, Peru. This course is an update and in Peru at the National Institute of Health where I work, a National Plan of Action for Antimicrobial Resistance has been organized in Peru, since 2016. Being a very serious Public Health problem.
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Walter Mario Caceres Leturia made a comment
This course of antimicrobial resistance will be very interesting, beneficial for its updating and practical application for health professionals. Thank you.
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Walter Mario Caceres Leturia made a comment
The information on demography allows me to adequately answer the questions and strengthen myself with the comments
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Population pyramids allow us to know the health needs of a given population, that is, infrastructure, human resources in health, immunization programs, human resources for productivity, food needs, etc.
In Peru 2016, women are 50.05%; the births are greater than the deaths, that is, the population is growing; from 0 to 14 is 27.7%, 15 to 64 is 65.3% and... -
Walter Mario Caceres Leturia made a comment
In Peru, the birth rate in rural areas is still high, infant mortality is still high. One of the factors that has generated diseases is the migration from the rural area to the city, due to terrorism problem, where we have overcrowding, does not have water services, etc., we have a high rate of tuberculosis due to these conditions. Life expectancy has...
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Walter Mario Caceres Leturia made a comment
This exercise on the demography of England shows us the need to know and project the characteristics of the population in terms of health, diseases, etc., and to prevent their need for health, nutrition, etc. as health personnel, health centers, etc. . In countries like Peru, there is a young population, the pregnancy in adolescents is very high, the measures...
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Walter Mario Caceres Leturia made a comment
With regard to the UK demographic information, you can get it online and the comments in some cases are presented as in other countries. In my country, Peru, in development, we have a different demographic population and more prevalent infectious diseases.
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Walter Mario Caceres Leturia made a comment
I think the course will be useful because it will update the concepts on Public Health
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Walter Mario Caceres Leturia made a comment
In Peru, in the mining activity, in lead smelting plants workers are monitored, in cadmium plant too, and according to the values, if they are high, they are removed from the work post and the concentrations of the workers are evaluated. metals in the work environment.
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Walter Mario Caceres Leturia made a comment
In Peru there is a regulation with permissible limits for chemical agents, in work environment, since 2005 being updated every 2 years, which is not done until today. Also the Ministry of Mining, is the one that requests the monitoring of the mines, they must report it; other activities almost do not report agents in the work environment.
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Walter Mario Caceres Leturia made a comment
The risk of chemical substances that are toxic by nature requires the employer to use an environment that decreases the agent (lead, CO, zinc etc.), give instructions to workers of good work practices, use of PPE and monitor the environment of these chemicals in values that do not cause harm to the health of the worker.
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In Peru, occupational diseases are reported in health personnel such as tuberculosis, viral hepatitis C, HIV, etc. recognized by the State. Also agriculture we have a lot of poisoning by plaguidas, which is not audited by the State.
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Walter Mario Caceres Leturia made a comment
In Peru, the compensation is given as a rule by a private insurance system, if accidents or illnesses increase, the insurance premium is increased, in such a way that companies try to take preventive measures to avoid accidents.
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Walter Mario Caceres Leturia made a comment
In Peru, some professional diseases such as silicosis, sensorineural deafness, etc, are legally compensated, the law also obliges through special medical insurance (Supplementary Risk Work Insurance), cover the medical attention until its recovery and its salary is maintained. until his reinstatement to work.
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Occupational diseases depending on the agents (physical, chemical and biological) or working conditions (ergonomic, postures, overload, etc., stress), will develop diseases or predispose to an accident. In Peru, mining is a very important activity. Formal companies, generally foreign, meet safety and health standards with workers.
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In Peru, occupational disease is legally a norm; we also have a list of occupational diseases, which derives from the ILO, is an open list that is to say if it shows causality of a agents or conditions with respect to any damage can be incorporated into the list of occupational diseases. The company also covers the costs through insurance, the medical recovery...
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Walter Mario Caceres Leturia made a comment
In Peru, the humid climate of Lima almost 90% of relative humidity, causes that many people present asthma or brincoespasmo, that generates problems in some works where they are exposed to dust with the consequent labor absenteeism due to bronchospasm crisis, it is not a restriction for work rather the occupational service of the company takes into account...
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Walter Mario Caceres Leturia made a comment
The dangers existing in this worker would be:
1) Electric current high voltage, drop height,
2) The load of electrical cables must be reduced, more electrical stations, use of protective equipment such as harnesses, gloves, lenses, dielectric boots.
3) In developing countries the costs are very high so the dangers remain in this case. -
Walter Mario Caceres Leturia made a comment
In Peru there are regulations on health and safety at work, for companies it is mandatory to comply, but when they are audited by the Ministry of Labor, they find that they do not comply with safety measures and neither the participation of workers is very low.
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Walter Mario Caceres Leturia made a comment
In Peru, the mining still reports serious or fatal accidents, civil construction follows, the latter requires the Ministry of Labor to supervise the construction works more often so that they comply with safety regulations.
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Walter Mario Caceres Leturia made a comment
In Peru, the Law 29783 Safety and Health in the Work, requires the employer to be responsible for the working conditions and the health of the worker, also obliges the reporting of occupational diseases monthly and fatal accidents in 24 hours, must be investigated by personnel of the Ministry of Labor. Unfortunately in Perù we have informal work that...
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Walter Mario Caceres Leturia made a comment
In this case of paint production factory, the danger is the toxic gases of the paint (the tiger-danger) and the working environment is inadequate (Cage).
The employer's measure of only the use of the PPE, is not enough is using a measure that does not protect the worker (low hierarchy).
You could prepare the paint outside the house outdoors, disperse the... -
Walter Mario Caceres Leturia made a comment
The hierarchy of control is very important to apply in high-risk work activities and it is necessary to combine the administrative, engineering and personal protective equipment use measures. Here in Peru there are rules that require companies to have their identification of hazards and risk assessment of jobs and on them apply preventive measures so that...
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Walter Mario Caceres Leturia made a comment
In Peru, the large mining by foreign companies comply with many measures to reduce exposure to dust by miners, also with occupational medical examinations, but other activities not as in agriculture with the use of pesticides reach the emergency many poisoned workers
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Walter Mario Caceres Leturia made a comment
In Peru, the Law requires that the employer is responsible for working conditions and the health of the worker. Requires the employer to perform hazard identification and risk assessment and worker health surveillance with occupational medical exams
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Walter Mario Caceres Leturia made a comment
In Peru, one of the main work accidents is in civil construction, falls with death. This is why the public opinion pressured the Ministry of labor that first began to recruit personnel for the audit, the occupational health law currently has a prison sentence to the employer, if there is negligence, other penalties are fines, closing of work etc.
And lawsuits... -
in Peru there is a Law 29783 Health and Safety at Work (2011), the Ministry of Labor supervises and the Ministry of Health sees accidents and occupational diseases, there are few human resources, so companies are not visited. And there is also informality at work, up to 70% in very dangerous work such as informal mining that uses mercury.
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in Peru, there is difficulty in obtaining real statistics on occupational diseases, it has been resumed strongly due to the development of the country, but there is a lack of professional resources with knowledge in occupational health and there is a high percentage of informal work with around 70%.
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Walter Mario Caceres Leturia made a comment
Occupational diseases have very long periods of manifestation but health surveillance can prevent it, along with the improvement of work conditions and personal protective equipment.
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I am a Medical specialist in Occupational Health. Work in Occupational Health at the National Institute of Health in Lima, Peru. The interesting topics on pesticide protection and know the occupational health in other countries.
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Walter Mario Caceres Leturia made a comment
Occupational health is very important for the development of the country and prevents occupational accidents and diseases.
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Walter Mario Caceres Leturia made a comment
Knowing the mechanisms of transmission of influenza virus allows to know the measures of prevention and control of the disease, such as hand washing, respiratory protection with masks, etc., although vaccination is the ideal measure
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Walter Mario Caceres Leturia made a comment
I have had severe flu-like illness with headache, chills, sore throat, malaise
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Walter Mario Caceres Leturia made a comment
In my health work, we are vaccinated against influenza, in the winter season where respiratory processes are more frequent
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Walter Mario Caceres Leturia made a comment
The Pantanos de Villa Wildlife Refuge is a protected natural area located on the coast of the Chorrillos district in the province of Lima, department of Lima in Peru.
Http://prohvilla.munlima.gob.pe/photos.html
ttps://www.youtube.com/watch?v=p-VcP_Rb5bI -
Walter Mario Caceres Leturia made a comment
In the Pantanos de Villa, in Chorrillos, in Lima, Peru; Receive during November and December more than 15 thousand birds, among them flamencos, solitary sandals, trinador curlers, semipalmados plovers, arctic plovers, peregrine falcons, migratory swallows, black-legged gaviotines, Wilson phallus.
The National Institute of Natural Resources (Inrena) is the... -
Walter Mario Caceres Leturia made a comment
In South America (Peru), we have not had outbreaks of H5N1 avian influenza, although in Peru, migratory wild birds from North America, mainly from Canada, arrive. There is little information on wild birds in South America, the presence and ecology of influenza virus type A.
With regard to the media in the face of an avian influenza epidemic in Peru, there is... -
Walter Mario Caceres Leturia made a comment
Avian influenza has a serious behavior both in birds and occasionally in humans. Genetic studies may now explain the serotypes of influenza that have affected humans, but can not predict how aggressive a mutated strain (pig, bird, human, etc.) will be, from a Public Health point of view. Surveillance of cases in birds as well as in humans.
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La filogenética en la influenza está permitiendo conocer los cambios que experimenta el virus de la gripe en el tiempo y el poder tener medidas de prevención de vacunas
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Extraordinary as the technology allowed to make a history of influenza virus and see what change they can give in the fence and affect the health of the people
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Walter Mario Caceres Leturia made a comment
The structure of the influenza virus (H and N), with such an antigenicity variety, does not allow permanent protection to people and we are exposed to become ill again, this requires a follow-up and study of the different influenza virus serotypes.
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Walter Mario Caceres Leturia made a comment
Although the N1N1 influenza, spread throughout Peru, personally do not experience infrequency but if other peprsona.
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Walter Mario Caceres Leturia made a comment
Influenza (H1N1) being an infectious process that caused considerable concern in my country (Peru), but with very low mortality. The motive of interest is the use of the vaccine for its control.
Thank you
