Hearing Loss and Associated 7-Year Cognitive Outcomes Among Hispanic and Latino Adults.

Importance: Hearing loss appears to have adverse effects on cognition and increases risk for cognitive impairment. These associations have not been thoroughly investigated in the Hispanic and Latino population, which faces hearing health disparities. Objective: To examine associations between hearing loss with 7-year cognitive change and mild cognitive impairment (MCI) prevalence among a diverse cohort of Hispanic/Latino adults. Design, Setting, and Participants: This cohort study used data from a large community health survey of Hispanic Latino adults in 4 major US cities. Eligible participants were aged 50 years or older at their second visit to study field centers. Cognitive data were collected at visit 1 and visit 2, an average of 7 years later. Data were last analyzed between September 2023 and January 2024. Exposure: Hearing loss at visit 1 was defined as a pure-tone average (500, 1000, 2000, and 4000 Hz) greater than 25 dB hearing loss in the better ear. Main outcomes and measures: Cognitive data were collected at visit 1 and visit 2, an average of 7 years later and included measures of episodic learning and memory (the Brief-Spanish English Verbal Learning Test Sum of Trials and Delayed Recall), verbal fluency (word fluency-phonemic fluency), executive functioning (Trails Making Test-Trail B), and processing speed (Digit-Symbol Substitution, Trails Making Test-Trail A). MCI at visit 2 was defined using the National Institute on Aging-Alzheimer Association criteria. Results: A total of 6113 Hispanic Latino adults were included (mean [SD] age, 56.4 [8.1] years; 3919 women [64.1%]). Hearing loss at visit 1 was associated with worse cognitive performance at 7-year follow-up (global cognition: ß = -0.11 [95% CI, -0.18 to -0.05]), equivalent to 4.6 years of aging and greater adverse change (slowing) in processing speed (ß = -0.12 [95% CI, -0.23 to -0.003]) equivalent to 5.4 years of cognitive change due to aging. There were no associations with MCI. Conclusions and relevance: The findings of this cohort study suggest that hearing loss decreases cognitive performance and increases rate of adverse change in processing speed. These findings underscore the need to prevent, assess, and treat hearing loss in the Hispanic and Latino community.

Epidemiologic Features of the Monkeypox Outbreak and the Public Health Response - United States, May 17-October 6, 2022.

On May 17, 2022, the Massachusetts Department of Health announced the first suspected case of monkeypox associated with the global outbreak in a U.S. resident. On May 23, 2022, CDC launched an emergency response (1,2). CDC's emergency response focused on surveillance, laboratory testing, medical countermeasures, and education. Medical countermeasures included rollout of a national JYNNEOS vaccination strategy, Food and Drug Administration (FDA) issuance of an emergency use authorization to allow for intradermal administration of JYNNEOS, and use of tecovirimat for patients with, or at risk for, severe monkeypox. During May 17-October 6, 2022, a total of 26,384 probable and confirmed* U.S. monkeypox cases were reported to CDC. Daily case counts peaked during mid-to-late August. Among 25,001 of 25,569 (98%) cases in adults with information on gender identity,† 23,683 (95%) occurred in cisgender men. Among 13,997 cisgender men with information on recent sexual or close intimate contact,§ 10,440 (75%) reported male-to-male sexual contact (MMSC) ≤21 days preceding symptom onset. Among 21,211 (80%) cases in persons with information on race and ethnicity,¶ 6,879 (32%), 6,628 (31%), and 6,330 (30%) occurred in non-Hispanic Black or African American (Black), Hispanic or Latino (Hispanic), and non-Hispanic White (White) persons, respectively. Among 5,017 (20%) cases in adults with information on HIV infection status, 2,876 (57%) had HIV infection. Prevention efforts, including vaccination, should be prioritized among persons at highest risk within groups most affected by the monkeypox outbreak, including gay, bisexual, and other men who have sex with men (MSM); transgender, nonbinary, and gender-diverse persons; racial and ethnic minority groups; and persons who are immunocompromised, including persons with advanced HIV infection or newly diagnosed HIV infection.

Telemedicina: desafíos para Chile a la luz de la experiencia de Estados Unidos durante la pandemia / Telemedicine: expected challenges in Chile based on the experience in the United States during the pandemic

Telemedicine has had a significant role during the outbreak of COVID-19. The experience in the United States has shown advantages and some challenges that need to be addressed to include telemedicine as an established part of the health system. This article aims to determine the United States' main challenges, associating them with the Chilean reality. In this study, we classify the barriers and difficulties for telemedicine into three areas: accessibility, cyber security, and medical liability.We argue that Chile will have to deal with similar obstacles to include telemedicine as a regular health service for the entire population.

[Telemedicine: expected challenges in Chile based on the experience in the United States during the pandemic]. / Telemedicina: desafíos para Chile a la luz de la experiencia de Estados Unidos durante la pandemia.

Telemedicine has had a significant role during the outbreak of COVID-19. The experience in the United States has shown advantages and some challenges that need to be addressed to include telemedicine as an established part of the health system. This article aims to determine the United States' main challenges, associating them with the Chilean reality. In this study, we classify the barriers and difficulties for telemedicine into three areas: accessibility, cyber security, and medical liability.We argue that Chile will have to deal with similar obstacles to include telemedicine as a regular health service for the entire population.

Osteonecrosis in individuals with systemic lupus erythematosus: a predictive model / Osteonecrosis en individuos con lupus eritematoso sistémico: un modelo predictivo

OBJECTIVE: This work attempts to provide a model to predict the development of osteonecrosis (ON) in individuals with systemic lupus erythematosus (SLE) using pharmacological, demographic, and psychoactive factors. METHOD: A review of the literature was conducted to construct a survey administered across Chile to individuals with SLE during a period of three weeks. This work used a sample size of 46 de-identified data records. Two Bayesian logistic regression models were created, with non-informative prior and informative prior distributions, and a random forest model was done for comparison. All models were cross-validated. RESULTS: The significant variables used were mean corticosteroids per day (mg) and tobacco use. The random forest model provided good accuracy and sensitivity, but low specificity. Bayesian logistic regression with prior information increased the specificity. CONCLUSIONS: This work determined that the use of corticosteroids and tobacco are significant variables to predict ON. Using prior information provides good accuracy, specificity, and sensitivity to the prediction. Further studies need to be conducted to validate the model using a testing set

OBJETIVO: Este trabajo busca determinar un modelo predictivo de desarrollo de osteonecrosis (ON) en individuos diagnosticados con lupus eritematoso sistémico (LES) utilizando factores farmacológicos, demográficos y psicoactivos. MÉTODO: Se realizó una revisión bibliográfica para construir una encuesta, la cual fue administrada a individuos con LES a lo largo de Chile durante un periodo de 3 semanas. En este trabajo se utilizó una muestra de 46 registros de datos no identificados. Se desarrollaron 2 modelos de regresión logística bayesiana con información a priori no informativa e informativa, y también se desarrolló un modelo comparativo utilizando bosques aleatorios. Los modelos fueron validados usando validación cruzada. RESULTADOS: Se usaron las variables significativas promedio de corticosteroides por día (mg) y consumo de tabaco. Bosques aleatorios provee una precisión y sensibilidad alta, pero una baja especificidad. La regresión logística bayesiana con información a priori incrementó el valor de la especificidad. CONCLUSIONES: Este trabajo ha determinado que el uso de corticosteroides y tabaco son variables significativas para predecir ON. Usando información a priori arroja buenos resultados en precisión, especificidad y sensibilidad en la predicción. Se requieren realizar más estudios aumentando el tamaño de la muestra para validar el modelo usando un conjunto de prueba

Osteonecrosis in individuals with systemic lupus erythematosus: A predictive model.

OBJECTIVE: This work attempts to provide a model to predict the development of osteonecrosis (ON) in individuals with systemic lupus erythematosus (SLE) using pharmacological, demographic, and psychoactive factors. METHOD: A review of the literature was conducted to construct a survey administered across Chile to individuals with SLE during a period of three weeks. This work used a sample size of 46 de-identified data records. Two Bayesian logistic regression models were created, with non-informative prior and informative prior distributions, and a random forest model was done for comparison. All models were cross-validated. RESULTS: The significant variables used were mean corticosteroids per day (mg) and tobacco use. The random forest model provided good accuracy and sensitivity, but low specificity. Bayesian logistic regression with prior information increased the specificity. CONCLUSIONS: This work determined that the use of corticosteroids and tobacco are significant variables to predict ON. Using prior information provides good accuracy, specificity, and sensitivity to the prediction. Further studies need to be conducted to validate the model using a testing set.