RESUMEN
BACKGROUND: Latin America has a high prevalence of Helicobacter pylori in children that may lead to peptic ulcer disease and eventually gastric cancer in adulthood. Successful eradication is hindered by rising antimicrobial resistance. We summarize H. pylori resistance rates in Latin American children from 2008 to 2023. MATERIAL AND METHODS: Systematic review following PRISMA guidelines and National Heart, Lung, and Blood Institute checklist to assess risk of bias (PROSPERO CRD42024517108) that included original cross-sectional observational studies reporting resistance to commonly used antibiotics in Latin American children and adolescents. We searched in PubMed, LILACS, and SciELO databases. RESULTS: Of 51 studies, 45 were excluded. The quality of the six analyzed studies (297 H. pylori-positive samples) was satisfactory. Phenotypic methods (N = 3) reported higher resistance rates than genotypic studies (N = 3). Clarithromycin resistance ranged from 8.0% to 26.7% (6 studies; 297 samples), metronidazole from 1.9% to 40.2% (4 studies; 211 samples), amoxicillin from 0% to 10.4% (3 studies; 158 samples), tetracycline resistance was not detected (3 studies; 158 samples), and levofloxacin resistance was 2.8% (1 study; 36 samples). CONCLUSION: Scarce Latin American studies on H. pylori resistance, along with methodological heterogeneity, hinder conclusive findings. Clarithromycin and metronidazole (first-line drugs) resistance is worrisome, likely impacting lower eradication rates. Urgent systematic surveillance or individual testing before treatment is necessary to enhance eradication.
Asunto(s)
Antibacterianos , Farmacorresistencia Bacteriana , Infecciones por Helicobacter , Helicobacter pylori , Humanos , Helicobacter pylori/efectos de los fármacos , Helicobacter pylori/genética , Helicobacter pylori/aislamiento & purificación , Infecciones por Helicobacter/microbiología , Infecciones por Helicobacter/tratamiento farmacológico , Infecciones por Helicobacter/epidemiología , América Latina/epidemiología , Adolescente , Niño , Antibacterianos/farmacología , Preescolar , Pruebas de Sensibilidad Microbiana , Estudios TransversalesRESUMEN
BACKGROUND: The digital revolution is creating opportunities and challenges in the field of medicine and the Digital Hospital could be a benefit for patients, if they are able to use the Internet. AIM: Identify the barriers that limit Internet use among stroke patients treated in a public hospital in Santiago. MATERIAL AND METHODS: Sociodemographic, clinical and functional variables that could influence the use of the Internet were collected in 107 patients with stroke. RESULTS: Seventy five percent of patients had access to the Internet, but only 29% knew how to use it before their hospitalization. Seventy five percent were older adults, 74% had a low level of education, 78% had an income below the minimum Chilean salary and 56% were discharged with a severe disability (modified Rankin Scale 4 or 5). There was a significant relationship between Internet use and the level of education, income and age. CONCLUSIONS: Income levels, age, schooling and stroke related disability limit Internet use in this population.
Asunto(s)
Accidente Cerebrovascular , Chile/epidemiología , Atención a la Salud , Instituciones de Salud , Humanos , Renta , Internet , Accidente Cerebrovascular/terapiaRESUMEN
Background: The digital revolution is creating opportunities and challenges in the field of medicine and the Digital Hospital could be a benefit for patients, if they are able to use the Internet. Aim: Identify the barriers that limit Internet use among stroke patients treated in a public hospital in Santiago. Material and Methods: Sociodemographic, clinical and functional variables that could influence the use of the Internet were collected in 107 patients with stroke. Results: Seventy five percent of patients had access to the Internet, but only 29% knew how to use it before their hospitalization. Seventy five percent were older adults, 74% had a low level of education, 78% had an income below the minimum Chilean salary and 56% were discharged with a severe disability (modified Rankin Scale 4 or 5). There was a significant relationship between Internet use and the level of education, income and age. Conclusions: Income levels, age, schooling and stroke related disability limit Internet use in this population.