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2.
Respirar (Ciudad Autón. B. Aires) ; 16(1): 31-43, Marzo 2024.
Article in Spanish | LILACS, UNISALUD, BINACIS | ID: biblio-1551189

ABSTRACT

Introducción: El cáncer de pulmón (CP) es una enfermedad con gran impacto a nivel mundial en el número de muertes y en costos en salud. La alta incidencia y mortalidad de esta enfermedad asociada al diagnóstico tardío, y la mejoría del pronóstico ante una detección temprana, determinan que sea una patología pasible de beneficiarse mediante detección temprana. La tomografía de baja dosis de radiación (TCBD) demostró ser un método que se pue- de realizar periódicamente a un grupo de personas con alto riesgo de desarrollar CP y así reducir la mortalidad por esta enfermedad. Sin embargo, este beneficio es tal cuan- do se encuentra desarrollado bajo un programa organizado y con participación multi- disciplinaria especializada en cáncer de pulmón. Métodos: Se plantea determinar lineamientos básicos para el desarrollo de la detección temprana de cáncer de pulmón en América Latina para que pueda ser realizada en forma uniforme, con el menor riesgo y el máximo beneficio esperado. Se analizaron las principales publicaciones referidas a este tema, contemplando la diversidad de atención y acceso de América Latina. Resultado: Se desarrollan requerimientos mínimos para la implementación de un pro- grama. Discusión: El número de programas en la región es escaso y depende más de esfuerzos individuales que de políticas generales de salud. Consideramos que estos lineamien- tos pueden servir de apoyo para el desarrollo de más programas en la región y de for- ma más homogénea.


Introduction: Lung cancer (LC) is a disease with a great impact worldwide in the number of deaths and health costs. The high incidence and mortality of this disease associated with late diagnosis and the improved prognosis with early detection determine that it is a pathology that can benefit from early detection. Low radiation dose tomography (LDCT) demonstrated a method that can be performed periodically to a group of people at high risk of developing CP and thus reduce mortality from this disease. However, this benefit is such when it is developed under an organized program with multidisciplinary participation specialized in lung cancer. Methods: It is proposed to determine basic guidelines for the development of early de- tection of lung cancer in Latin America so that it can be carried out uniformly, with the lowest risk and the maximum expected benefit. The main publications referring to this topic were analyzed, considering the diversity of care and access in Latin America. Result: Minimum requirements are developed for the implementation of a program. Discussion: The number of programs in the region is small and depends more on individual efforts than on general health policies. We consider that these guidelines can serve as support for the development of more programs in the region and in a more ho- mogeneous way.


Subject(s)
Humans , Health Programs and Plans , Early Detection of Cancer , Lung Neoplasms/diagnosis , Patient Care Team/organization & administration , Preventive Health Services/organization & administration , Tomography/methods , Incidence , Mortality , Education, Professional , Health Policy , Latin America
3.
Int. j. morphol ; 42(1): 185-196, feb. 2024. ilus, tab, graf
Article in English | LILACS | ID: biblio-1528838

ABSTRACT

SUMMARY: The new paradigm in Forensic Sciences initiated by the entry of genetics (the current standard of legal evidence) and accentuated by recognized wrongful convictions derived from experts today in the eye of criticism, has highlighted the potential for bias and error in forensic disciplines when they depend on human interpretation and subjectivity, which has not been avoided by Forensic Odontology (FO). However, a subjective judgment is not necessarily wrong, so the refinement of processes, the development of standards, and robust research can contribute to the validity of interpretation to increase objectivity. Latin America (LATAM) has its own realities and needs, which have conditioned the priorities and objectives of FO research. A scoping review is presented to systematically map the investigation of LATAM researchers and identify the objective or subjective nature of their assessments. LATAM shows interesting productivity and intentions to adhere to international standards, with Brazil leading this research significantly, followed by Chile and Colombia, among others. However, there is a disproportionate approach in certain lines of research (dental age estimation), and needs to address other quantitative studies, and to improve the visibility of the LATAM FO research.


El nuevo paradigma en ciencias forenses iniciado por la entrada de la genética (el actual estándar de la evidencia jurídica), y acentuado por reconocidas condenas injustas derivadas de pericias hoy en el ojo de la crítica, ha destacado el potencial de sesgo y error que poseen algunas disciplinas forenses cuando dependen de la interpretación humana y la subjetividad, lo cual no ha sido ajeno a la odontología forense (OF). Sin embargo, un juicio subjetivo no necesariamente es erróneo, con lo que el refinamiento de procesos, el desarrollo de estándares y la investigación robusta pueden contribuir a validar esa interpretación para aumentar su objetividad. Latinoamérica (LATAM) posee realidades y necesidades propias que han condicionado las prioridades y objetivos de la investigación en OF. Se presenta una revisión con búsqueda sistemática para mapear sistemáticamente la investigación en OF realizada por investigadores latinoamericanos, así como identificar la naturaleza objetiva o subjetiva de sus evaluaciones. LATAM demuestra una productividad interesante e intenciones de adherirse a estándares internacionales, con Brasil liderando significativamente esta investigación, seguido por Chile y Colombia entre otros. Sin embargo, se observa un enfoque desproporcionado en ciertas líneas de investigación (estimación de edad dental particularmente), y necesidad tanto de abordar otros estudios cuantitativos como de mejorar la visibilidad de la investigación latinoamericana en OF.


Subject(s)
Humans , Research , Forensic Dentistry , Data Interpretation, Statistical , Qualitative Research , Latin America
4.
São Paulo; s.n; 2024. 191 p.
Thesis in Portuguese | LILACS | ID: biblio-1554020

ABSTRACT

Introdução: No capitalismo contemporâneo em crise, os sistemas de saúde de todo o mundo estão sendo sistematicamente enfraquecidos devido à aplicação de contrarreformas sociais por meio de políticas neoliberais/ultraneoliberais promovidas pelo Estado capitalista. Por um lado, observa-se um permanente subfinanciamento público, e por outro lado, há uma inserção, reprodução e ampliação da lógica de mercado neoliberal no setor saúde. Esse processo tem transformado a saúde em um setor voltado para a acumulação de capital e a busca incessante por sua maior valorização. Objetivo: Analisar a produção cientifica latino-americana sobre o financiamento dos sistemas de saúde na América Latina no capitalismo contemporâneo em crise, com a finalidade de compreender como os autores latino-americanos discutem o financiamento da saúde à luz do pensamento crítico de Navarro, a partir de sua obra "La Medicina bajo el Capitalismo", de 1978. Método: Inicialmente, realizou-se uma revisão da literatura sobre a saúde no capitalismo contemporâneo em crise. Em seguida, realizou-se uma revisão integrativa, a partir da pergunta: Como a literatura cientifica, especialmente latino-americana, vem discutindo o financiamento dos sistemas de saúde na América Latina no capitalismo contemporâneo em crise? A busca bibliográfica foi realizada na Biblioteca Virtual de Saúde, em 3 de fevereiro de 2023, encontrando-se 265 publicações, e incluindo-se, após o processo de seleção, 23 artigos na revisão integrativa. Por fim, realizou-se uma análise comparativa, identificando convergências e divergências entre os resultados da revisão à luz do pensamento crítico de Vicente Navarro López. Resultados: Os artigos incluídos na revisão foram classificados em eixos temáticos: 65,2% discutiram o financiamento e a privatização da saúde e cobertura universal de seguro de saúde; 47,8%, o financiamento em meio a processos de reforma do setor saúde; 43,5%, o subfinanciamento público da saúde; 39,1%, o financiamento em meio a processos de reforma fiscal ou tributária ou busca de novas fontes de financiamento para a saúde; 26,1%, o financiamento em meio a processos de descentralização da saúde; e 17,4%, o financiamento em meio a processos constituintes ou de implementação de novas constituições políticas. Enquanto as convergências e divergências entre os resultados desses artigos e as contribuições do pensamento crítico de Navarro, identificou-se que 39,1% tiveram alguma aproximação ao método de estudo marxista, em oposição ao funcionalismo; 30.4% foram críticos com os supostos da teoria das etapas do desenvolvimento na abordagem da saúde; 47,8% e 21,7% abordaram os determinantes econômicos e políticos do subdesenvolvimento da saúde e do direito à saúde, respectivamente; e 26,1% discutiram a influência das agências internacionais nas decisões de política de saúde. Conclusões: Os pesquisadores latino-americanos no campo do financiamento da saúde enfrentam os desafios de estudá-lo dialeticamente com o cenário econômico, político e social das próprias sociedades capitalistas em que a saúde está inserida, e de incorporar em sua análise a determinação social da saúde no capitalismo contemporâneo em crise. A transição da economia da saúde para a econômica política crítica da saúde exige que esses pesquisadores superem esses desafios para integrar esses elementos em suas futuras investigações no campo do financiamento da saúde.


Introduction: In contemporary capitalism in crisis, health systems around the world are being systematically weakened due to the application of social counter-reforms through neoliberal/ultraneoliberal policies promoted by the capitalist state. On the one hand, there is permanent public underfunding, and on the other hand, there is an insertion, reproduction and expansion of the neoliberal market logic in the health sector. This process has transformed health into a sector focused on the accumulation of capital and the incessant search for its greater appreciation. Objective: To analyze the Latin American scientific production on the financing of health systems in Latin America in contemporary capitalism in crisis, in order to understand how the Latin-American authorsAmericans discuss health financing in light of Navarros critical thinking, from his 1978 work "La Medicina bajo el Capitalismo". Method: Initially, a review of the literature on health in contemporary capitalism in crisis was carried out. Then, an integrative review was carried out, based on the question: How has the scientific literature, especially Latin American, been discussing the financing of health systems in Latin America in contemporary capitalism in crisis? The bibliographic search was performed in the Virtual Health Library, on February 3, 2023, with 265 publications, and including, after the selection process, 23 articles in the integrative review. Finally, a comparative analysis was carried out, identifying convergences and divergences between the results of the review in the light of the critical thinking of Vicente Navarro López. Results: The articles included in the review were classified in thematic bundles: 65.2% discussed the financing and privatization of health and universal health insurance coverage; 47.8%, financing in the midst of health sector reform processes; 43.5%, public health underfunding; 39.1%, financing in the midst of fiscal or tax reform processes or seeking new sources of health funding; 26.1%, financing in the midst of health decentralization processes; and 17.4%, funding in the midst of constituent processes or the implementation of new political constitutions. While the convergences and divergences between the results of these articles and the contributions of Navarros critical thinking, it was identified that 39.1% had some approximation to the Marxist method of study, as opposed to functionalism; 30.4% were critical of the supposed theory of stages of development in the approach to health; 47.8% and 21.7% addressed the economic and political determinants of underdevelopment of health and the right to health, respectively; and1% discussed the influence of international agencies on health policy decisions. Conclusions: Latin American researchers in the field of health financing face the challenges of studying it dialectically with the economic, political and social scenario of capitalist societies themselves in which health is inserted, and to incorporate in its analysis the social determination of health in contemporary capitalism in crisis. The transition from health economics to critical health policy economics requires these researchers to overcome these challenges to integrate these elements into their future research in the field of health finance.


Subject(s)
Capitalism , Healthcare Financing , Health System Financing , Latin America
6.
Rev. chil. obstet. ginecol. (En línea) ; 88(5): 301-307, oct. 2023. tab
Article in Spanish | LILACS | ID: biblio-1530018

ABSTRACT

INTRODUCCIÓN: El virus del papiloma humano (VPH), con más de 100 tipos, es de transmisión sexual. Varios países de América Latina han introducido las vacunas contra el VPH. Aunque América Latina es la región que más rápido avanzó en la vacunación contra el VPH, sus sistemas de seguimiento y vigilancia son aún deficientes. OBJETIVO: Comparar las diferentes estrategias de vacunación contra el VPH en Ecuador y América Latina. MÉTODO: Revisión bibliográfica, en la que se obtuvo información de documentos gubernamentales y artículos indexados en los últimos 5 años sobre las estrategias de vacunación contra el VPH en Ecuador y América Latina. RESULTADOS: La mayoría de los países de América Latina han logrado introducir la vacuna contra el VPH, excepto Venezuela, Martinica, Haití, Nicaragua y Cuba. CONCLUSIONES: Los protocolos de vacunación de Ecuador y América Latina necesitan mejorar sus sistemas de seguimiento y aumentar la expansión de datos de cobertura disponibles de manera consistente. Actualmente siguen existiendo desafíos para introducir las vacunas, lograr una alta cobertura y fortalecer el seguimiento, la evaluación y la notificación.


INTRODUCTION: The human papilloma virus (HPV), with more than 100 types, is a sexual transmission infection. Many Latin American countries have introduced the vaccines against the HPV. Although Latin América is the region which advanced faster against the HPV, its surveillance and follow-up systems are yet deficient. OBJECTIVE: To compare the different strategies to assume the vaccination against the HPV in Ecuador and Latin America. METHOD: Bibliographic review, in which information was obtained from government documents and articles indexed in the last five years on vaccination strategies against HPV in Ecuador and Latin America. RESULTS: Most Latin American countries have managed to introduce the vaccine against the HPV, except Venezuela, Martinica, Haiti, Nicaragua and Cuba. CONCLUSIONS: The vaccination protocols of Ecuador and Latin América need to improve their systems of follow-up and monitoring, and increase the expansion of available data in a consistent manner. Now, there are still existing challenges to introduce the vaccines, manage a high reach and fortify the follow-up, the evaluation, and the notification.


Subject(s)
Humans , Female , Immunization Programs , Papillomavirus Infections/prevention & control , Papillomavirus Vaccines , Immunization Schedule , Ecuador , Latin America
8.
Rev. ADM ; 80(4): 214-219, jul.-ago. 2023. ilus, tab
Article in Spanish | LILACS | ID: biblio-1526847

ABSTRACT

La microbiota oral está conformada por diversas especies bacterianas que en condiciones normales desempeñan una función protectora del huésped; sin embargo, cuando existe un desequilibrio en el ecosistema, estos microorganismos son capaces de producir diversas manifestaciones como lo es el caso de la caries dental, enfermedad infecciosa producida principalmente por Streptococcus mutans, patógeno capaz de desmineralizar los tejidos duros del diente mediante la fermentación de hidratos de carbono obtenidos de la dieta. Se ha identificado en la pared celular de este microorganismo ocho serotipos que intervienen en la adhesión, agregación y coagregación bacteriana. En los seres humanos S. mutans presenta los serotipos c, e y f, siendo el serotipo c el más prevalente a nivel mundial, el cual se conoce que está asociado a pacientes sanos, a diferencia del e y f que son capaces de invadir las células endoteliales de las arterias coronarias. No obstante, en los últimos años se ha logrado identificar el serotipo k que de igual manera presenta alta capacidad de invadir el endotelio humano, actuando en la patogénesis de las enfermedades cardiovasculares. El objetivo de la presente revisión bibliográfica es lograr cuantificar los serotipos prevalentes de S. mutans en América Latina (AU)


The oral microbiota is made up of various bacterial species that under normal conditions perform a protective function of the host, however, when there is an imbalance in the ecosystem, these microorganisms are capable of producing various manifestations such as caries, an infectious disease. produced mainly by Streptococcus mutans, a pathogen capable of demineralizing the hard tissues of the tooth through the fermentation of carbohydrates obtained from the diet. Eight serotypes involved in bacterial adhesion, aggregation and coaggregation have been identified in the cell wall of this microorganism. In humans, S. mutans presents serotypes c, e, and f, serotype c being the most prevalent worldwide, which is known to be associated with healthy patients, unlike e and f, which are capable of invading the endothelial cells of the coronary arteries. However, in recent years it has been possible to identify serotype k, which also has a high capacity to invade the human endothelium, acting in the pathogenesis of cardiovascular diseases. The objective of this literature review is to quantify the prevalent serotypes of S. mutans in Latin America (AU)


Subject(s)
Humans , Streptococcus mutans , Dental Caries/microbiology , Serogroup , Bacterial Adhesion , Latin America/epidemiology
11.
In. Roitman, Adriel Jonas. Ética en investigación: Nuevos desafíos, ¿viejos dilemas?. Ciudad de Buenos Aires, Gobierno de la Ciudad de Buenos Aires. Ministerio de Salud. Dirección General de Docencia, Investigación y Desarrollo Profesional, jun. 2023. p.9-14.
Monography in Spanish | LILACS, InstitutionalDB, BINACIS, UNISALUD | ID: biblio-1437589

ABSTRACT

Presentación de "Estudio Exploratorio de los Marcos de Gobernanza para la Revisión y Supervisión Ética de la Investigación de COVID-19 en América Latina", trabajo descriptivo para identificar si los países de América Latina adoptaron políticas para acelerar la evaluación ética de las investigaciones, a la vez de que aseguraban los estándares éticos para su realización, durante la pandemia.


Subject(s)
Ethics Committees, Research/trends , Ethics Committees, Research/ethics , Ethics, Research , COVID-19/prevention & control , Practice Guideline , Latin America
12.
Rev. Asoc. Méd. Argent ; 136(2): 13-17, jun. 2023.
Article in Spanish | LILACS | ID: biblio-1551242

ABSTRACT

El vocablo "universidad" viene del latín universitas, término que hace referencia a "totalidad" o "reunido en un todo". Históricamente fue conformado por el grupo de "los que enseñan" y el de "los que aprenden". Una de las primeras universidades fue la Universidad de Bologna donde si bien predominaban los estudios jurídicos, también se dictaban filosofía, teología, farmacia, astronomía, matemáticas y medicina. Su contrapartida fue la Universidad de París, donde se enseñaba fundamentalmente teología. En esta última institución los pontífices se reservaron la vigilancia de su actuación y enseñanza. La universidad moderna surge del modelo de Guillermo Humboldt, en el que se restablece la coexistencia de la ciencia y la investigación, que constituyen el germen de nuestra relación docencia - investigación. En las universidades de América Latina se destaca la reforma universitaria de Córdoba, uno de cuyos puntos centrales fue la autonomía universitaria, definida como la facultad de los estudiantes de dirigir la Universidad sin la intromisión de los poderes del estado, en el ámbito propio de la deliberación y la decisión libre de los alumnos y maestros, despojados de toda autoridad diferente a su capacidad docente. (AU)


The word "university" comes from the Latin universitas, a term that refers to "totality" or "united as a whole". Historically it was formed by the group of "those who teach" and "those who learn". One of the first universities was the University of Bologna where, although legal studies predominated, philosophy, theology, pharmacy, astronomy, mathematics and medicine were also taught. Its counterpart was the University of Paris, where theology was the main subject. In the latter institution, the pontiffs reserved for themselves the supervision of their actions and teaching. The modern university arises from the model of William Humboldt, in which the conjunction of science and research is reestablished, which constitute the germ of our teaching-research relationship. In Latin American universities, the university reform of Córdoba stands out, one of the central points of which was university autonomy defined as the faculty of students to direct the University, without the interference of the powers of the state, in the proper scope of deliberation and free decision of students and teachers, stripped of any other authority different from their teaching capacity. (AU)


Subject(s)
Universities/trends , Education, Medical/history , Argentina , Teaching , Universities/history , History of Medicine , Latin America
13.
Rev. cuba. med. gen. integr ; 39(1)mar. 2023.
Article in Spanish | CUMED, LILACS | ID: biblio-1508256

ABSTRACT

Introducción: En Colombia, las pruebas de Estado para la evaluación de la calidad de los programas de educación superior (Saber Pro) tienen por objeto evaluar los conocimientos y capacidades profesionales de todos los estudiantes que han cumplido la mayoría de los créditos en sus programas académicos. Adicionalmente, estas pruebas son un requisito complementario al internado rotatorio para graduarse como profesional en medicina. Sin embargo, existen cuestionamientos relacionados con su utilidad en el ejercicio laboral y la articulación de estas pruebas con la formación médica. Objetivo: Establecer la coherencia entre la prueba Saber Pro y la educación médica. Métodos: Se realizó una revisión narrativa, mediante la búsqueda en PubMed, Ovid, Elsevier, SciELO y la normativa del contexto colombiano. Resultados: De acuerdo con la búsqueda realizada, existe un número considerable de artículos que soportan la aplicación de esta prueba, fundamentados en resultados cualitativos que se relacionan con la adaptación de instrumentos de evaluación médica. Asimismo, algunas fuentes muestran la influencia que pueden tener las competencias evaluadas con indicadores de salud y otros aspectos del contexto nacional. Conclusiones: Pese al número limitado de estudios que permitan dar conclusiones de carácter cuantitativo, existe evidencia sobre la utilidad y coherencia de la Prueba de Estado en el contexto nacional, de igual forma, se establece que la prueba Saber Pro puede garantizar estándares de calidad en los programas de educación superior y, con el paso del tiempo, ha contribuido al desarrollo de recomendaciones para la transformación de la educación médica en Colombia(AU)


Introduction: In Colombia, the state tests for evaluating the quality of higher education programs (Saber Pro) are intended to evaluate the professional knowledge and skills of all students who have completed the majority of credits in their academic programs. Additionally, these tests are a complementary requirement before the rotation internship for graduating as a medical professional. However, there are questions related to their usefulness in the occupational practice and the articulation of these tests with the medical training. Objective: To establish the coherence between the Saber Pro tests and medical education. Methods: A narrative review was carried out by means of a search in PubMed, Ovid, Elsevier, SciELO and the regulations of the Colombian context. Results: According to the search carried out, there is a considerable number of articles that support the application of this test, based on qualitative results related to the adaptation of medical evaluation instruments. Likewise, some sources show the influence that the assessed competences may have, by means of health indicators and other aspects of the national context. Conclusions: Despite the limited number of studies that allow provide quantitative conclusions, there is evidence on the usefulness and coherence of the state test in the national context; likewise, the Saber Pro test is concluded to be able to guarantee quality standards in higher education programs and, with the passage of time, has contributed to the development of recommendations for the transformation of medical education in Colombia(AU)


Subject(s)
Professional Competence , Competency-Based Education , Education, Medical , Educational Measurement , Colombia , Latin America
14.
Online braz. j. nurs. (Online) ; 22: e20236643, 01 jan 2023. ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1438026

ABSTRACT

OBJETIVO: Sintetizar estudos qualitativos sobre as experiências de luto após um natimorto em pais que vivem na América Latina. MÉTODO: Revisão sistemática qualitativa realizada em quatro bases de dados eletrônica e que utilizou o Guideline Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ). A qualidade metodológica dos estudos incluídos foi avaliada usando o Critical Appraisal Skills Programme e uma síntese temática foi realizada. RESULTADOS: Um total de 110 estudos foram encontrados e quatro estudos eleitos com base nos critérios de elegibilidade. Quatro temas apresentam a experiência de luto parental: impacto, sofrimento e transformação após a morte fetal; preocupação com o corpo do bebê falecido; insatisfação com a qualidade da assistência em saúde; e família e religião como principais fontes de apoio. CONCLUSÃO: A natimortalidade na América Latina precisa ser explorada em pesquisas futuras e ainda é marcada pela desassistência no processo de luto.


OBJECTIVE: To synthesize qualitative studies on Latin American parents' grieving experiences after a stillbirth. METHOD: A systematic qualitative review was conducted in four electronic databases using the Enhancing Transparency in Reporting the Synthesis of Qualitative Research (ENTREQ) guideline. The methodological quality of included studies was assessed using the Critical Appraisal Skills Programme, and a thematic synthesis was performed. RESULTS: One hundred ten studies were found, and four were chosen based on the eligibility criteria. Four themes were identified concerning the experience of parental grieving: impact, suffering, and transformation after fetal death; preoccupation with the deceased baby's body; dissatisfaction with the quality of health care; and family and religion as the primary sources of support. CONCLUSION: Stillbirth in Latin America must be explored in future research, and a lack of assistance still marks the grieving process.


Subject(s)
Humans , Parents , Bereavement , Stillbirth , Latin America , Qualitative Research
15.
Rev. neuro-psiquiatr. (Impr.) ; 86(1): 45-61, ene. 2023. tab, ilus
Article in Spanish | LILACS, LIPECS | ID: biblio-1442084

ABSTRACT

La Ataxia de Friedreich (AF) es una enfermedad neurodegenerativa autosómica recesiva con compromiso multisistémico. En esta revisión, se actualizan aspectos epidemiológicos, fisiopatológicos y clínico-terapéuticos y se conduce una búsqueda sistemática de casos de AF reportados en Latinoamérica. La prevalencia de AF en poblaciones caucásicas es estimada entre 2 y 5 casos por 100 000 habitantes. En Latinoamérica se han publicado 35 estudios que reúnen 1481 casos en 6 países. Causada por la expansión anormal de repeticiones GAA en el gen FXN, la etiopatogenia está asociada a una reducción en los niveles de la proteína frataxina (que altera el metabolismo energético) y el acúmulo de hierro mitocondrial. El fenotipo clásico de AF suele comenzar antes de los 25 años, aunque hay otros de inicio tardío y retención de reflejos. La sintomatología se caracteriza por ataxia progresiva, alteración sensitiva, arreflexia, disartria, y alteraciones oculomotoras, además de compromiso cardiaco, endocrino y musculoesquelético. El diagnóstico requiere evaluación neurológica detallada, estudios neurofisiológicos, neuroimágenes y pruebas bioquímicas pero el enfoque determinante es el estudio genético que demuestre variantes genéticas bialélicas en el gen FXN. El manejo es multidisciplinario, orientado a aminorar los síntomas, prevenir complicaciones y brindar asesoramiento genético apropiado. Recientemente se ha aprobado el primer tratamiento farmacológico para AF con varios más en fases de experimentación.


SUMMARY Friedreich Ataxia (FA) is an autosomal recessive neurodegenerative disease with multisystemic involvement. This update of epidemiological, pathophysiological, and clinico-therapeutic aspects of FA, includes a systematic review of cases in Latin America. The estimated FA prevalence in Caucasian populations is between 2 to 5 cases per 100 000. In Latin America, 1481 cases have been published in 35 articles from six different countries. Caused by an abnormally repeated expansion of GAA trinucleotide inside the FXN gene, FA's etiopathogenesis is associated with reduced levels of the frataxin protein, which disturb the energy metabolism and result in mitochondrial iron accumulation. The classic phenotype usually shows symptoms before the age of 25, although there are others with a later onset. The main symptoms of AF are progressive ataxia, sensory disturbances, areflexia, dysarthria, and oculomotor alterations, in addition to cardiac, endocrine, and musculoskeletal compromise. Diagnostic workup requires a detailed neurological examination, neuroconduction studies, neuroimaging, and biochemical tests. The definitive diagnosis is provided by genetic testing showing biallelic variants within the FXN gene. The management is multidisciplinary, aimed at reducing symptoms, preventing complications, and providing an appropriate genetic counseling. Recently, the first pharmacological treatment for AF has been approved, with several others in clinical assessment trials.


Subject(s)
Humans , Young Adult , Ataxia , Friedreich Ataxia , Iron-Binding Proteins , Genes, Recessive , Latin America , Case Reports
16.
Rev. panam. salud pública ; 47: e26, 2023. tab, graf
Article in Spanish | LILACS | ID: biblio-1424252

ABSTRACT

RESUMEN Objetivo. Agrupar las barreras para el conocimiento, tratamiento y control de la hipertensión en pacientes de América Latina mediante una revisión de alcance. Métodos. Se realizó una revisión de alcance de acuerdo con el marco metodológico de Arksey y O'Malley y las directrices para revisiones sistemáticas y metaanálisis (PRISMA). Se efectuó una búsqueda en las bases de datos PubMed, Biblioteca Virtual de Salud y Scopus. La selección se realizó de manera independiente y en ciego en el aplicativo RAYYAN QCRI®. Por último, se abordaron los resultados de los estudios seleccionados de manera narrativa. Resultados. Se incluyeron ocho estudios cualitativos y cuantitativos que se adecuaban a nuestra pregunta de investigación. Las barreras descritas con más frecuencia son las propias del sistema que dificultan el acceso integral y equitativo a la atención médica y los medicamentos, la ausencia de programas educativos e intervenciones personalizadas que mejoren la adherencia a tratamientos y los cambios en el estilo de vida. El factor económico es crítico en América Latina e impide el acceso al sistema de salud y modificar el estilo de vida debido a los costos del transporte, las citas médicas y los medicamentos. Conclusiones. Las barreras detectadas afectan todas las dimensiones para la adherencia al tratamiento; entre ellas se destacan la falta de educación y posicionamiento de los tomadores de decisiones en la atención de la hipertensión.


ABSTRACT Objective. Group the barriers to knowledge, treatment, and control of hypertension in patients in Latin America through a scoping review. Methods. A scoping review was conducted in accordance with the Arksey and O'Malley methodological framework and the PRISMA guidelines for systematic reviews and meta-analyses. Searches were carried out in the PubMed, Virtual Health Library, and Scopus databases. Blind and independent selection was conducted in the RAYYAN QCRI application. Finally, the results of the selected studies were addressed narratively. Results. Eight qualitative and quantitative studies that fit the research question were included. The most frequently described barriers are systemic barriers that hinder comprehensive and equitable access to health care and medication, as well as a lack of educational programs, personalized interventions to improve adherence to treatments, and lifestyle changes. Economic factors are critical in Latin America, hindering access to the health system and changes to lifestyles due to the costs of transportation, medical appointments, and medicines. Conclusions. The detected barriers affect all dimensions of adherence to treatment; among the most important barriers are decision makers who lack education and positioning with respect to care of hypertension.


RESUMO Objetivo. Compilar as barreiras ao conhecimento, tratamento e controle da hipertensão arterial em pacientes da América Latina por meio de uma revisão de escopo. Métodos. Foi realizada uma revisão de escopo de acordo com a estrutura metodológica de Arksey e O'Malley e as diretrizes PRISMA para revisões sistemáticas e metanálises. Foi realizada uma busca nas bases de dados PubMed, Biblioteca Virtual em Saúde e Scopus. A seleção foi realizada de forma independente e cega no aplicativo RAYYAN QCRIâ. Por último, os resultados dos estudos selecionados foram abordados de forma narrativa. Resultados. Foram incluídos oito estudos qualitativos e quantitativos que se enquadravam na nossa questão de pesquisa. As barreiras mais frequentemente descritas são aquelas próprias do sistema que dificultam o acesso integral e equitativo a atendimento médico e medicamentos, a ausência de programas educativos e intervenções personalizadas que melhorem a adesão ao tratamento e as mudanças no estilo de vida. O fator econômico é crítico na América Latina e impede o acesso ao sistema de saúde para modificar o estilo de vida devido aos custos de transporte, consultas médicas e medicamentos. Conclusões. As barreiras detectadas afetam todas as dimensões da adesão ao tratamento, entre as quais se destaca a falta de capacitação e posicionamento dos tomadores de decisão sobre o cuidado da hipertensão.


Subject(s)
Humans , Health Knowledge, Attitudes, Practice , Treatment Adherence and Compliance , Hypertension/prevention & control , Hypertension/drug therapy , Sociodemographic Factors , Latin America
17.
Rev. panam. salud pública ; 47: e17, 2023. tab
Article in English | LILACS | ID: biblio-1424260

ABSTRACT

ABSTRACT The Faculty of Health Sciences at the Universitat Oberta de Catalunya (Barcelona, Spain) was officially designated a 'World Health Organization (WHO) Collaborating Centre in eHealth' on 5 April 2018. The Centre aims to provide support to countries willing to develop new telemedicine services; to promote the use of eHealth; and to study the adoption and use of mobile health in countries of both the Region of the Americas and Europe. On 11 March 2020, WHO declared COVID-19 a global pandemic given the significant increase in the number of cases worldwide. Since then, the Centre has played an important role in addressing COVID-19 by undertaking fruitful cooperative activities. Lockdowns and social distancing in response to the high contagion rate of COVID-19 were the main triggers for a challenging digital transformation in many sectors, especially in healthcare. In this extreme crisis scenario, the rapid adoption of digital health solutions and technological tools was key to responding to the enormous pressure on healthcare systems. Telemedicine has become a necessary component of clinical practice for the purpose of providing safer patient care, and it has been used to support the healthcare needs of COVID-19 patients and routine primary care patients alike. This article describes the Centre's contribution to the work of the Pan American Health Organization (PAHO) and WHO in supporting Latin American and European countries to develop new telemedicine services and guidance on how to address COVID-19 through digital health solutions. Future actions are also highlighted.


RESUMEN La Facultad de Ciencias de la Salud de la Universitat Oberta de Catalunya (Barcelona, España) fue oficialmente designada centro colaborador de la Organización Mundial de la Salud (OMS) en el ámbito de la salud digital (también denominada "cibersalud" o "eSalud") el 5 de abril del 2018. El centro está destinado a prestar apoyo a los países que deseen crear nuevos servicios de telemedicina, promover el uso de la salud digital, y estudiar la adopción y el uso de la salud móvil en países de la Región de las Américas y Europa. El 11 de marzo del 2020 la OMS declaró la COVID-19 una pandemia mundial dado el aumento significativo del número de casos en todo el mundo. Desde entonces, el centro ha desempeñado un papel importante en la respuesta a la COVID-19 mediante la realización de fructíferas actividades de cooperación. Los confinamientos y el distanciamiento social en respuesta a la alta tasa de contagio de la COVID-19 fueron los principales desencadenantes de una compleja transformación digital en muchos sectores, especialmente en la atención de salud. En esta situación de crisis extrema, la rápida adopción de soluciones digitales y herramientas tecnológicas fue clave para dar respuesta a la enorme presión sobre los sistemas de salud. La telemedicina se ha convertido en un componente necesario de la práctica clínica con el fin de proporcionar una atención más segura a los pacientes, y se ha empleado para apoyar las necesidades de atención de salud de los pacientes con COVID-19 así como los pacientes habituales de los servicios de atención primaria. En este artículo se describe la contribución del centro a la labor de la Organización Panamericana de la Salud (OPS) y la OMS al prestar apoyo a los países de América Latina y Europa en la creación de nuevos servicios de telemedicina y brindar orientación sobre cómo abordar la COVID-19 con soluciones digitales de salud. También se destacan las acciones futuras.


RESUMO A Faculdade de Ciências da Saúde da Universitat Oberta de Catalunya (Barcelona, Espanha) foi oficialmente designada, em 5 de abril de 2018, "Centro Colaborador da Organização Mundial da Saúde (OMS) em eSaúde". O centro tem como objetivo prestar apoio aos países dispostos a desenvolver novos serviços de telemedicina; promover o uso da eSaúde, ou saúde digital; e estudar a adoção e o uso da saúde móvel em países da Região das Américas e da Europa. Em 11 de março de 2020, a OMS declarou a COVID-19 como pandemia global, dado o aumento significativo do número de casos no mundo inteiro. Desde então, o centro tem desempenhado um papel importante no enfrentamento da COVID-19, empreendendo atividades frutíferas de cooperação. Os lockdowns e o distanciamento social em resposta à alta taxa de contágio da COVID-19 foram os principais desencadeadores de uma transformação digital desafiadora em muitos setores, especialmente na área da saúde. Neste cenário de crise extrema, a rápida adoção de soluções digitais de saúde e ferramentas tecnológicas foi fundamental para responder à enorme pressão sobre os sistemas de saúde. A telemedicina se tornou um componente necessário da prática clínica, com o objetivo de oferecer um atendimento mais seguro aos pacientes, e tem sido usada para apoiar as necessidades de saúde tanto dos pacientes com COVID-19 como dos pacientes da atenção primária de rotina. Este artigo descreve a contribuição do centro para o trabalho da Organização Pan-Americana da Saúde (OPAS) e da OMS no apoio aos países latino-americanos e europeus para desenvolver novos serviços de telemedicina e orientação sobre como enfrentar a COVID-19 por meio de soluções de saúde digitais. Ações futuras também são destacadas.


Subject(s)
Humans , Telemedicine/methods , eHealth Strategies , COVID-19/therapy , Health Promotion/methods , Pan American Health Organization , Congresses as Topic , Latin America
18.
Rev. panam. salud pública ; 47: e34, 2023. tab, graf
Article in English | LILACS | ID: biblio-1424274

ABSTRACT

ABSTRACT Objectives. To characterize the distribution profile of dengue, chikungunya, and Zika virus infections in Latin America and the Caribbean and to identify possible factors associated with the risk of dissemination and severity of these arboviruses. Methods. The protocol of this review was registered on the PROSPERO platform. Searches were carried out in the following databases: Virtual Health Library, MEDLINE/PubMed, and Embase. The search terms were: Zika virus, Zika virus infection, dengue, dengue virus, chikungunya virus, chikungunya fever, epidemiology, observational study, Latin America, and Caribbean region. Studies that addressed the distribution of these arboviruses and the risk factors associated with dengue, Zika virus disease, and chikungunya, published between January 2000 and August 2020 in English, Portuguese, and Spanish, were included. Results. Of 95 studies included, 70 identified risk factors, clinical manifestations, and outcomes for arbovirus infections and 25 described complications and/or deaths. The highest frequency of confirmed cases was for dengue. Brazil reported most cases of the three arboviruses in the period analyzed. Environmental and socioeconomic factors facilitated the proliferation and adaptation of vectors, and host-related factors were reported to aggravate dengue. Most deaths were due to chikungunya, Zika virus disease caused most neurological alterations, and dengue resulted in greater morbidity leading to more frequent hospitalization. Conclusions. The review provides a broad view of the three arboviruses and the intrinsic aspects of infections, and highlights the factors that influence the spread of these viruses in the populations studied.


RESUMEN Objetivos. Caracterizar el perfil de distribución de infecciones por dengue, chikungunya y el virus de Zika en América Latina y el Caribe, y determinar posibles factores relacionados con el riesgo de propagación y gravedad de estas arbovirosis. Métodos. Se registró el protocolo de esta revisión en la plataforma PROSPERO. Se realizaron búsquedas en las siguientes bases de datos: Virtual Health Library, MEDLINE/PubMed y Embase. Los términos de búsqueda fueron: "zika virus" [virus del Zika], "zika virus infection" [infección por el virus del Zika], "dengue", "dengue virus" [virus del dengue], "chikungunya virus" [virus del chikunguña], "chikungunya fever" [fiebre de chikunguña], "epidemiology" [epidemiología], "observational study" [estudio observacional], "Latin America" [América Latina] y "Caribbean región" [Caribe]. Se incluyeron estudios que abordaban la distribución de estas arbovirosis y los factores de riesgo asociados con el dengue, la enfermedad por el virus del Zika y el chikunguña, publicados entre enero del 2000 y agosto del 2020 en español, inglés y portugués. Resultados. De los 95 estudios incluidos, 70 establecieron factores de riesgo, manifestaciones clínicas y resultados de las infecciones por arbovirus y 25 describieron complicaciones o muertes. La mayor frecuencia de casos confirmados fue del dengue. Brasil notificó la mayoría de los casos de infección por los tres arbovirus en el período analizado. Los factores ambientales y socioeconómicos facilitaron la proliferación y adaptación de los vectores, y se notificó que los factores relacionados con el huésped agravaban el dengue. El chikunguña causó la mayor parte de las muertes, la enfermedad por el virus del Zika causó la mayor parte de las alteraciones neurológicas y el dengue fue responsable de una mayor morbilidad, lo que llevó a una hospitalización más frecuente. Conclusiones. Esta revisión ofrece un panorama de las tres arbovirosis y de los aspectos intrínsecos de las infecciones, y pone de relieve los factores que influyen en la propagación de estos virus en las poblaciones estudiadas.


RESUMO Objetivos. Descrever a distribuição das arboviroses causadas pelo vírus da dengue, zika e chikungunya na América Latina e no Caribe e identificar possíveis fatores associados ao potencial de disseminação e à gravidade dessas infecções. Métodos. O protocolo desta revisão sistemática foi registado na plataforma PROSPERO. Foram realizadas buscas nas bases de dados Biblioteca Virtual em Saúde, MEDLINE/PubMed e Embase. Os termos de busca foram: vírus zika, infecção pelo vírus zika, dengue, vírus da dengue, vírus chikungunya, febre chikungunya, epidemiologia, estudo observacional, América Latina e região do Caribe. Foram selecionados estudos publicados em inglês, português e espanhol, entre janeiro de 2000 e agosto de 2020, que tratavam da distribuição desses arbovírus e de fatores de risco associados à dengue, à infecção pelo vírus zika e à febre chikungunya. Resultados. Dos 95 estudos selecionados, 70 descreveram fatores de risco, manifestações clínicas e desfechos das arboviroses e 25 destacaram as complicações e/ou mortes. Houve uma maior taxa de casos confirmados de dengue. O Brasil foi o país onde se registrou a maioria dos casos dessas três arboviroses no período analisado. Fatores ambientais e socioeconômicos facilitaram a proliferação e a adaptação dos vetores dos arbovírus e fatores próprios do hospedeiro são determinantes na gravidade da dengue. As mortes ocorreram principalmente nos casos de febre chikungunya, as manifestações neurológicas foram mais comuns na infecção pelo vírus zika e a dengue resultou em maior morbidade e internação hospitalar. Conclusões. Esta revisão sistemática oferece um panorama destas três arboviroses e de suas peculiaridades destacando os fatores que influenciam a disseminação destes arbovírus nas populações estudadas.


Subject(s)
Humans , Dengue/epidemiology , Chikungunya Fever/epidemiology , Zika Virus Infection/epidemiology , Socioeconomic Factors , Incidence , Risk Factors , Latin America/epidemiology
19.
In. Aya Pastrana, Nathaly; Besada Paullier, Inés; Garré Castro, Laura; González Bula, Gabriela; León, Carolina de. Mercadeo social para la salud pública: cambios de comportamientos para el bien social. [Montevideo], Comisión Honoraria para la Salud Cardiovascular, [2023?]. p.30-34.
Monography in Spanish | LILACS, UY-BNMED, BNUY | ID: biblio-1424930
20.
BMC pregnancy childbirth ; 23(1): 605, 2023.
Article in English | LILACS, BNUY, MMyP, UY-BNMED | ID: biblio-1518570

ABSTRACT

Background: Latin America has the highest Cesarean Section Rates (CSR) in the world. Robson's Ten Group Classification System (RTGCS) was developed to enable understanding the CSR in different groups of women, classified according to obstetric characteristics into one of ten groups. The size of each CS group may provide helpful data on quality of care in a determined region or setting. Data can potentially be used to compare the impact of conditions such as maternal morbidity on CSR. The objective of this study is to understand the impact of Severe Maternal Morbidity (SMM) on CSR in ten different groups of RTGCS. Methods: Secondary analysis of childbirth information from 2018 to 2021, including 8 health facilities from 5 Latin American and Caribbean countries (Bolivia, Guatemala, Honduras, Nicaragua, and the Dominican Republic), using a surveillance database (SIP-Perinatal Information System, in Spanish) implemented in different settings across Latin America. Women were classified into one of RTGCS. The frequency of each group and its respective CSR were described. Furthermore, the sample was divided into two groups, according to maternal outcomes: women without SMM and those who experienced SMM, considering Potentially Life-threatening Conditions, Maternal Near Miss and Maternal Death as the continuum of morbidity. Results: Available data were obtained from 92,688 deliveries using the Robson Classification. Overall CSR was around 38%. Group 5 was responsible for almost one-third of cesarean sections. SMM occurred in 6.7% of cases. Among these cases, the overall CSR was almost 70% in this group. Group 10 had a major role (preterm deliveries). Group 5 (previous Cesarean section) had a very high CSR within the group, regardless of the occurrence of maternal morbidity (over 80%). Conclusion: Cesarean section rate was higher in women experiencing SMM than in those without SMM in Latin America. SMM was associated with higher Cesarean section rates, especially in groups 1 and 3. Nevertheless, group 5 was the major contributor to the overall CSR. (AU)


Subject(s)
Humans , Female , Pregnancy , Infant, Newborn , Cesarean Section , Pentaerythritol Tetranitrate , Parturition , Latin America/epidemiology
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