Plants used in Guatemala for the treatment of protozoal infections: II. Activity of extracts and fractions of five Guatemalan plants against Trypanosoma cruzi.

The activities of crude plant extracts of five plants popularly used in Guatemala against bacterial and protozoal infections and some of their fractions have been evaluated against the trypomastigote and epimastigote forms of Trypanosoma cruzi in vitro. The most active fraction of Neurolaena lobata has also been screened in vivo. Main in vitro activities against trypomastigotes have been observed for the hexane and ethanol extracts of N. lobata (Asteraceae). Both extracts were also active against epimastigotes, whereas all other extracts tested had no effect on epimastigotes. For the hexane extracts of Petiveria alliacea (Phytolaccaceae) and Tridax procumbens (Asteraceae) a marked inhibition of trypomastigotes has been found. Also the ethanol extracts of Byrsonima crassifolia (Malpighiaceae) leafs and Gliricidia sepium (Papilionaceae) bark showed some trypanocidal activity. Fraction 2 of the ethanol extract of N. lobata was highly active against T. cruzi as well in vitro as in vivo. The chloroforme fraction of P. alliacea showed a high inhibition of trypomastigotes in vitro. Also three fractions of the active extract of B. crassifolia inhibited T. cruzi trypomastigotes. No fraction of G. sepium bark extract showed a marked trypanocidal activity.

An outbreak of mumps in the Province of León Spain 1995-1996.

In Spain mumps vaccine is given at the age of 15 months together with measles and rubella vaccines since 1982. Increased numbers of cases and outbreaks of mumps appeared in several autonomous communities in 1995. An outbreak of mumps in the province of.

An outbreak of mumps in the Province of Leon Spain 1995-1996.

In Spain mumps vaccine is given at the age of 15 months together with measles and rubella vaccines since 1982. Increased numbers of cases and outbreaks of mumps appeared in several autonomous communities in 1995. An outbreak of mumps in the province of -

-Factors of dissatisfaction with health care. A Delphi study-. / Factores de insatisfacción con la asistencia sanitaria. Un estudio Delphi.

OBJECTIVE: To study the causes of the disagreement between the general atmosphere of insatisfaction inherent in the assistance offered by the health care system and the favourable evaluation that the public shows in the questionnaires carried out in the field of primary health care. The less satisfactory issues of the health service offert are also identified. DESIGN: A Delphi thecnique has been used as consensus method. SETTING: Community setting: Salamanca urban area. PARTICIPANTS: The Delphi group is made up of people working in jobs with a pronounced social character: members of neighbour associations, educators, social workers, etc. Three consecutive questionnaires were distributed among fifty people. Twenty-seven of them completed the three rounds. MEASUREMENTS AND MAIN RESULTS: The score of the reasons of disagreement perceived as the most important were: the difficulties of access at a specialised level, 8.3 points; the inequality of the services offered by the two organizative models that coexist in the primary health care, 7.1; the lack of discrimination between the primary and the specialized level, 6.8. The highest scores were for the following complaints: excessive waiting lists at the second care level (8.5), delay in solving the problems (7.8) and masification at the consultancy (7.1). The most satisfactory aspects are the possibility of free choice of doctor, 7.9 points; the previous appointement system, 7.6; and a reliable relationship with the doctor, 7.3. CONCLUSIONS: To take into account these factors in the future design and interpretation of inquiries will increase their information validity and usefulness.