Bringing the Pediatric Endocrine Spanish Speaking Community Together: First Virtual Pediatric Endocrine Meeting in Low- and Middle-Income Countries in Central and South America.

BACKGROUND: Pediatric endocrinology is a specialty that is struggling worldwide to maintain adequately trained professionals. Pediatric endocrine care in Central America and Caribbean countries is often performed by pediatricians or adult endocrinologists due to the limited number of pediatric endocrinologists. These health care providers are seldom members of endocrine societies and frequently lack formal training in the field. OBJECTIVE: In this study, we describe the scope of a virtual conference in pediatric endocrinology and diabetes targeted to low- and middle-income countries to provide equal opportunities for access to medical education for health care professionals. METHODS: The virtual conference was sponsored by the Pediatric Endocrine Society (North America), Asociación Costarricense de Endocrinología (previously, Asociación Nacional Pro Estudio de la Diabetes, Endocrinología y Metabolismo), and Asociacion Centroamericana y del Caribe de Endocrinologia Pediátrica. The conference was free to participants and comprised 23 sessions that were either synchronous with ability for real-time interactive sessions or asynchronous sessions, where content was available online to access at their convenience. Topics included idiopathic short stature, polycystic ovarian syndrome, diabetes mellitus, telemedicine, Turner syndrome, congenital adrenal hyperplasia, obesity, central precocious puberty, and subclinical hypothyroidism. The participants were asked to evaluate the conference after its completion with a questionnaire. RESULTS: A total of 8 speakers from Spain, Canada, Costa Rica, and the United States delivered the virtual event to 668 health care professionals from Guatemala, Venezuela, Dominican Republic, Costa Rica, Ecuador, Peru, Uruguay, Mexico, Honduras, Argentina, the United States, Bolivia, Chile, Panama, El Salvador, Nicaragua, Paraguay, Belize, Spain, and Colombia. Name, profession, and country were fully disclosed by 410 (61.4%) of the 668 health care professionals. The profession or level of training of participants were as follows: pediatric endocrinologists (n=129, 19.3%), pediatricians (n=116, 17.4%), general practitioners (n=77, 11.5%), adult endocrinologists (n=34, 5.1%), medical students (n=23, 3.4%), residents in various specialties (n=14, 2.1%), and others (n=17, 2.6%). A total of 23 sessions were offered, most of which were bilingual (Spanish and English). Feedback from the evaluation questionnaire indicated that the content of the conference was very relevant to the participants' professional practice. Additionally, the participants reported that they were very satisfied with the organization, the web-based platform, and the sessions of the conference. CONCLUSIONS: Lack of accessibility to the latest and cutting-edge medical education in pediatric endocrinology and diabetes for medical professionals from low- and middle-income countries can be overcome with a virtual conference. Online availability, low cost, and easy-to-use technology were well received from the participants, who were overall very satisfied by the quality and the relevance of the sessions to their professional practice.

Diabetes mellitus neonatal en Costa Rica / Neonatal diabetes mellitus in Costa Rica

La diabetes mellitus neonatal es un raro desorden metabólico usualmente desarrollado en las primeas 6 semanas de vida, secundario a un grupo de mutaciones y defectos del desarrollo pancreático que puede desembocar en una catástrofe clínica si no se identifica tempranamente; se divide en una variante transitoria y una permanente, siendo la primera la más frecuente, con cerca de un 60 por ciento de los casos. El manejo inicial de ambas variantes es la insulinoterapia intensiva, que en la variante transitoria puede suspenderse usualmente en los primeros meses de vida...

Pros y contras de la creación del hospital contra el cáncer en Costa Rica / Pros and cons of the creation of the hospital against cancer in Costa Rica

La relevancia que representa para el país la creación del hospital oncológico es controversial, porque se ha recibido amplia cobertura de los noticieros, donde se han hecho muy importantes denuncias, y parte de la poblaciones estudiadas para este trabajo, están en contra de este proyecto, 25 por ciento de los médicos no le encuentra el beneficio directo. En cuanto a quien debería manejar dicho hospital, ambas poblaciones (médicas y civiles) concordaron que la CCSS es el organismo que debe encargarse del manejo. Al ICCC (Instituto Costarricense Contra el Cáncer) se le ha relacionado solamente con la construcción del edificio del hospital que atienda el cáncer, pero la ley 7765 lo establece como órgano encargado de la investigación, capacitación, prevención y tratamiento de esta enfermedad, por lo que es necesario llevar a cabo un análisis financiero de costos que dé a conocer cuáles serían los beneficios y qué cambios implicaría la creación de un hospital oncológico, pero para que las cosas funcionen en orden, la transparencia y la comunicación se vuelven imprescindibles. A pesar de todo, es probable que la creación de este centro especializado en cáncer implicaque una diferencia significativa en la situación de salud del paciente con cáncer en nuestro país. Palabras clave: Hospital oncológico, proyecto, médicos, beneficio directo, manejo, CCSS, ICCC (Instituto Costarricense Contra el Cáncer), cáncer, ley 7765, investigación, capacitación, prevención, tratamiento, transparencia.