Commercial Speech and the Prohibition of Tobacco Advertising: The Colombian Constitutional Court Approach.

This article argues that the decision by the Columbian high court to totally ban the advertising and promotion of tobacco products is sound and could indeed be applied to other types of harmful products.

Serum hemato-immunological biomarkers associated with increased COVID-19 mortality in the Latino population.

Introduction: COVID-19 hospitalizations and deaths have raised the need of identifying prognostic factors for medical decision-making. Methods: Observational, retrospective study analyzing 191 COVID-19 patients' serum inflammatory biomarkers. Results: The median age was 48.7 ± 12.7 years, 75.9% being men. Overweight/obesity was the most common comorbidity in 83.8% of patients. 44.5% had moderate disease followed by 43.5% with severe disease. The mean percentage of pulmonary damage was 53.4% ± 28.7. Serum leukocyte-to-lymphocyte ratio >7.7, neutrophil-to-lymphocyte ratio >10, platelet-to-lymphocyte ratio ≥250 and nutritional index <362 all were independent mortality predictors for COVID-19. Conclusions: A leukocyte-to-lymphocyte ratio >7.7 as well as a nutritional index <362 at hospitalization were independently associated with an increased mortality.

Latin American consensus on uncomplicated recurrent urinary tract infection-2018.

An estimated 20-30% of adult women who experience an initial urinary tract infection (UTI) will have recurrent infection. In these patients, prophylaxis may be considered to improve their quality of life and control overuse of antibiotics. Despite this need, there is currently no Latin American consensus on the treatment and prophylaxis of recurrent UTIs. This consensus, signed by a panel of regional and international experts on UTI management, aims to address this need and is the first step toward a Latin American consensus on a number of urogynecological conditions. The panel agrees that antibiotics should be considered the primary treatment option for symptomatic UTI, taking into account local pathogen resistance patterns. Regarding prophylaxis, immunoactive therapy with the bacterial lysate OM-89 received a grade A recommendation and local estrogen in postmenopausal women grade B recommendation. Lower-grade recommendations include behavior modification and D-mannose; probiotics (Lactobacilli), cranberries, and hyaluronic acid (and derivatives) received limited recommendations; their use should be discussed with the patient. Though considered effective and receiving grade A recommendation, antimicrobial prophylaxis should be considered only following prophylaxis with effective non-antimicrobial measures that were not successful and chosen based on the frequency of sexual intercourse and local pathogen resistance patterns.

Tobacco control litigation: broader impacts on health rights adjudication.

This paper argues that there are instances in which tobacco control litigation is strengthening the justiciability of the right to health and health-related rights. This is happening in different parts of the world, but in particular in Latin America. In part this is because, to a certain extent, tobacco control litigation based on fundamental rights overcomes the traditional arguments against economic, social and cultural rights adjudication: the anti-democratic argument, the lack of technical competency argument, the problem of the misallocation of scarce public resources and the problem of the implementation of judicial decisions. As we analyzed in this paper, tobacco control cases based on fundamental rights are allowing courts to elaborate on broader standards of judicial adjudication of social rights, e.g., expand notions of standing, progressive realization, and state obligations enshrined in the right to health. Key to this judicial trend is the Framework Convention on Tobacco Control, which provides a legal standard - supported by scientific evidence - defining concrete measures states should take to address the tobacco epidemic, and thus giving content to the right to health as it relates to tobacco control.

Restrições à publicidade e promoção do tabaco e a liberdade de expressão: conflito de direitos? / Freedom of expression and the regulation of tobaccoadvertising and promotion: rights in tension?

A Convenção-Quadro para o Controle do Tabaco (CQCT), da Organização Mundial da Saúde, tratado internacional com crescentes conexões com o direito internacional de direitos humanos, estabelece políticas de controle do tabaco que são recomendáveis. Entre elas destacam-se a proibição absoluta da publicidade e da promoção de produtos do tabaco. Até o presente momento essas medidas tiveram limitada aceitação em nível global, havendo poucos países que as implementaram. Do mesmo modo, embora haja diferentes casos judiciais que vinculam a regulação da publicidade e a promoção com a liberdade de expressão,há poucos antecedentes que discutem expressamente uma proibição total. A recente decisão da Corte Constitucional da Colômbia a esse respeito permite fundamentar uma posição que vincula a publicidade e a promoção de tabaco com as liberdades comerciais, mais do que com a liberdade de expressão. Essa diferenciação confere a possibilidade de estabelecer restrições mais estritas, como uma proibição total de publicidade e promoção, seguindo a CQCT. Ante as graves consequências geradas pela epidemia de tabagismo no mundo e considerando o papel-chave da publicidade e da promoção do tabaco em sua propagação, essas políticas se justificam como respostas exigidas no marco das obrigações derivadas do direito humano à saúde.

Pandemic (H1N1) 2009 outbreak on pig farm, Argentina.

In June-July 2009, an outbreak of pandemic (H1N1) 2009 infection occurred on a pig farm in Argentina. Molecular analysis indicated that the virus was genetically related to the pandemic (H1N1) 2009 influenza virus strain. The outbreak presumably resulted from direct human-to-pig transmission.

[Metabolic study results of 54 patients with high risk of recurrent urolitiasis]. / Resultados del estudio metabólico en 54 pacientes con urolitiasis de alto riesgo de recurrencia.

INTRODUCTION: Urolithiasis is a metabolic disorder with a tendency to relapse. The aim of this study was to assess the prevalence of metabolic abnormalities in patients at high risk and the impact of sex and age. MATERIALS AND METHODS: Descriptive study of 54 patients (37 men and 17 women), with lithiasic pathology at high risk of recurrence. The metabolic study included the measurement of calcemia, uricemia, fosfemia, parathormone, calciuria/24 h, uricosuria/24 h, fosfaturia/24 h, oxalaturia/24 h, citraturia/24 h and creatinine/24 h. The values obtained were corrected according to weight and creatinine. The test used for statistical analysis was t-student (STATA 7.0). It was considered significant p<0.05. RESULTS: In 64,8% (35/54) of the cases a metabolic abnormality was observed and in 27,7% (15/54) there was 2 or more alterations present. The metabolic disorders most frequently observed were hypercalciuria (15/54) 27,7%, hypocitraturia (15/54) 27,7%, hyperuricemia (8/54) 14,8%. and hyperoxaluria (8/54) 14,8%. There was no significant difference in age or sex between the groups with and without metabolic abnormality. CONCLUSIONS: Most patients with recurrent lithiasic pathology or at high-risk display one or more metabolic disorders, being hypercalciuria and hypocitraturia the most frecuently encountered. In this study, there was no difference between sexes in most of the metabolic disorders, nor in its age distribution. These results demonstrate the need for metabolic studies in high-risk patients, since there are tools that allow therapeutic medical management of metabolic disorders and thus reduce the recurrence of lithiasis.

[Prospective study and comparative of surgical and oncologic outcome between laparoscopic and retropubical radical prostatectomy]. / Estudio prospectivo no randomizado comparando los resultados funcionales y oncológicos entre la prostatectomía radical retropúbica y laparoscópica.

INTRODUCTION: Radical prostatectomy (RP) is a potentially healing surgical procedure. OBJECTIVE: We evaluate and compare the surgical and oncologic outcomes between laparoscopic and retropubical radical prostatectomy in the Urology Department in DIPRECA Hospital. METHOD: We constructed a nonrandomised, prospective study between january 2003 and march 2007. A total of 115 patients, 56 operated laparoscopically and 59 by retropubical RP. Functional and oncologic results were compared according to standardized variables and their corresponding statistical analysis, for which we used SPSS 12.0 program. RESULTS: Mean operation time was 202,5 minutes for laparoscopic RP and 150,5 for retropubical RP (p<0.0001). Retropubical RP required more blood transfusions (p<0.0001), longer hospital stay (p=0,0073) and longer need for vesical catheter (p=0,0001) than laparoscopic RP. There were 23 complications, 15 attributable to laparoscopic RP. We found no significant differences in postsurgical sexual function and urinary continence. In respect to the oncologic variables, we found no statistically relevant differences in positive surgical margins nor biochemical relapse during follow up. CONCLUSION: We found no significant differences between retropubical and laparoscopic RP in the oncologic and functional variables analyzed. Nevertheless, our experience shows a distinct benefit in favour of the laparoscopic approach in relation to bleeding and recovery rate. Though retropubical RP has a shorter operating time, we believe this variable depends on the learning curve still developing for laparoscopic RP. According to our literary review, this is the first publication in Chile that compares both techniques.

Factores epidemiológicos del embarazo ectópico / Epidemiological factors of the ectopic pregnancy

Con el objetivo de evaluar algunos factores epidemiológicos del embarazo ectópico, se realizó un estudio prospectivo y longitudinal de todas las pacientes que ingresaron por esta afección en el Hospital Docente Comandante Pinares entre los años 1998 y 1999. El grupo estudio estuvo formado por 80 pacientes, mientras que el grupo control fue formado por 85 pacientes. Ambos grupos se escogieron de forma aleatoria. Las variables analizadas fueron: edad, antecedentes obstétricos, utilización y tipo de anticonceptivo, antecedentes de enfermedad inflamatoria pélvica y antecedente y tipo de enfermedad de transmisión sexual. Para el análisis de los datos se utilizó el porcentaje, la media, la desviación estándar, y el estadígrafo Z con un nivel de significación de p<0,05 (significativo). Se obtuvo un predominio del grupo de 25 a 29 años, con significación estadística para las nulíparas, las mujeres que utilizaron anticonceptivos y, específicamente las que tenían dispositivo intrauterino; también se encontraron resultados significativos con relación al control en aquellas pacientes que presentaron una enfermedad inflamatoria pélvica y antecedentes de enfermedad de trasmisión sexual, con especial énfasis en las que tuvieron trichomoniasis y sífilis. Se concluyó que los elementos antes mencionados constituyeron factores de riesgo para que se produzca un embarazo ectópico

Leucemia linfoblastica aguda simuladora de osteomielitis / Acute linfoblastic leucemia osteomyelitis simulation

Se relata el caso de una pre-escolar femenina de cuatro años de edad quien inicio su enfermedad con un cuadro articular y posterior lesión ósea a nivel de perone derecho, siete meses antes que su médula ósea apareciesen blastos que hicieran el diagnostico de leucemia linfoblastica aguda. Se destaca la importancia de la biopsia de la lesion ósea acompañada siempre de médula ósea, ya que la primera por si sola puede no ser concluyente como en este caso, asi mismo incluir a las leucemias dentro del diagnóstico diferencial de toda patología osteo-articular de evolucion torpida y con poca respuesta al tratamiento