RESUMO
OBJECTIVE: A narrative overview of regional academic research collaborations to address the increasing burden and gaps in care for patients at risk of, and who suffer from, stroke in Latin America (LA). MATERIALS AND METHODS: A summary of experiences and knowledge of the local situation is presented. No systematic literature review was performed. RESULTS: The rapidly increasing burden of stroke poses immense challenges in LA, where prevention and manage-ment strategies are highly uneven and inadequate. Clinical research is increasing through various academic consortia and networks formed to overcome structural, funding and skill barriers. However, strengthening the ability to generate, analyze and interpret randomized evidence is central to further develop effective therapies and healthcare systems in LA. CONCLUSIONS: Regional networks foster the conduct of multicenter studies -particularly randomized controlled trials-, even in resource-poor regions. They also contribute to the external validity of international studies and strengthen systems of care, clinical skills, critical thinking, and international knowledge exchange.
Assuntos
Atenção à Saúde , Acidente Vascular Cerebral , Competência Clínica , Humanos , América Latina , Organizações , Acidente Vascular Cerebral/epidemiologia , Acidente Vascular Cerebral/terapiaRESUMO
The presence of moderate to severe paravalvular leak increases mortality. We present a case of giant paravalvular leak closure using the 3-dimensional printing model to assess the success of the device to be used for its closure, computed tomography was performed for planning and guiding the procedure by image fusion. (Level of Difficulty: Advanced.).
RESUMO
El cáncer de cabeza y cuello es una patología prevalente a nivel mundial. Su abordaje consiste, en buena parte de los casos, de quimiorradioterapia, la cual, dentro de sus múltiples consecuencias, compromete la anatomía y el funcionamiento de órganos relacionadas a la deglución, generando disfagia orofaríngea. En ese sentido, el manejo fonoaudiológico predominantemente se lleva a cabo con ejercicios implementados posterior a la manifestación de la disfagia, con creciente interés sobre el manejo profiláctico del cuadro, existiendo variados estudios sobre la utilidad de ejercicios y maniobras relacionadas. En consecuencia, el objetivo de la presente revisión es presentar recursos terapéuticos basados en evidencia de calidad para el manejo proactivo de esta alteración, orientando la decisión clínica sobre su uso.
Head and neck cancer is a worldwide prevalent pathology. Its approach consists, in most cases, on chemoradiotherapy. Within its multiple consequences, compromises anatomy and functioning of structures related to swallowing, generating oropharyngeal dysphagia. In this context, Speech and Language Pathologist management is predominantly carried out with exercises implemented after the manifestation of dysphagia, existing increasing interest in prophylactic management of the condition, with several studies on the usefulness of exercises and related available maneuvers. Consequently, the objective of the present review is to present therapeutic resources based on good quality evidence for the proactive management of this alteration, guiding the clinical decision on its use.