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1.
Rev Peru Med Exp Salud Publica ; 38(2): 318-325, 2021.
Artigo em Espanhol | MEDLINE | ID: mdl-34468583

RESUMO

Reports of infection and/or disease caused by non-tuberculous mycobacteria (NTM) are becoming increasingly frequent. This scope review describes the epidemiological and clinical trend of infection/disease caused by NTM in Latin America. OVID MEDLINE, Embase and LILACS databases were explored for relevant articles. After filtering, we included 44 articles, representing an overall population of 2,826 subjects diagnosed with NTM infection and disease; the majority of the publications included subjects from Brazil and Colombia (75%), cross-sectional studies were the most common (36.6%), most subjects were male (61.3%) and the median age of subjects was 40.1 years. Disease by NTM was reported in 37 publications, extrapulmonary presentation was the most frequent (54%), main comorbidities were other pulmonary diseases, HIV, cystic fibrosis, diabetes and malnutrition, as reported in 13 studies; tuberculosis diagnosis previous to NTM disease was reported in 15 articles. Aesthetic procedures were reported in 12 articles while clinical procedures were reported in 3 articles. Several NTM species were reported, being Mycobacterium avium (52%), M. abscessus (34%), M. chelonae (18%), M. fortuitum (16%) and M. kansasii (9.1%) the most frequent. Culture and molecular testing were the main methods for diagnosis and identification. Scientific literature on NTM from Latin American countries is scarce. There is an urgent need to conduct studies on the frequency and clinical impact of NTM infections, in order to accurately identify the current morbidity and mortality associated with NTM in Latin American. It is also important to strengthen the local diagnostic capacity and the existing networks focused on studying NTM.


Assuntos
Infecções por Mycobacterium não Tuberculosas , Tuberculose , Adulto , Estudos Transversais , Humanos , América Latina/epidemiologia , Masculino , Infecções por Mycobacterium não Tuberculosas/diagnóstico , Infecções por Mycobacterium não Tuberculosas/epidemiologia , Micobactérias não Tuberculosas , Tuberculose/diagnóstico , Tuberculose/epidemiologia
2.
Recurso na Internet em Inglês, Espanhol, Português | LIS - Localizador de Informação em Saúde | ID: lis-48322

RESUMO

A diretora da Organização Pan-Americana da Saúde (OPAS), Carissa F. Etienne, informou nesta quarta-feira (11) que o organismo internacional utilizará seu Fundo Rotatório para ajudar os países da América Latina e do Caribe a adquirir vacinas suficientes para controlar a transmissão da COVID-19.


Assuntos
Vacinas , COVID-19 , América Latina/epidemiologia , Região do Caribe/epidemiologia , Organização Pan-Americana da Saúde
3.
Blood Adv ; 5(15): 3032-3046, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34374748

RESUMO

BACKGROUND: Venous thromboembolism (VTE) is a common disease in Latin American settings. Implementing international guidelinn Aes in Latimerican settings requires additional considerations. OBJECTIVE: The purpose of our study was to provide evidence-based guidelines about managing VTE for Latin American patients, clinicians, and decision makers. METHODS: We used the Grading of Recommendations, Assessment, Development and Evaluation (GRADE)-ADOLOPMENT method to adapt recommendations from 2 American Society of Hematology (ASH) VTE guidelines (Treatment of VTE and Anticoagulation Therapy). ASH and local hematology societies formed a guideline panel comprised of medical professionals from 10 countries in Latin America. Panelists prioritized 18 questions relevant for the Latin American context. A knowledge synthesis team updated evidence reviews of health effects conducted for the original ASH guidelines and summarized information about factors specific to the Latin American context (ie, values and preferences, resources, accessibility, feasibility, and impact on health equity). RESULTS: The panel agreed on 17 recommendations. Compared with the original guideline, 4 recommendations changed direction and 1 changed strength. CONCLUSIONS: This guideline adolopment project highlighted the importance of contextualization of recommendations suggested by the changes to the original recommendations. The panel also identified 2 implementation priorities for the region: expanding the availability of home treatment and increasing the availability of direct oral anticoagulants (DOACs). The guideline panel made a conditional recommendation in favor of home treatment for individuals with deep venous thrombosis and a conditional recommendation for either home or hospital treatment for individuals with pulmonary embolism. In addition, a conditional recommendation was made in favor of DOACs over vitamin K antagonists for several populations.


Assuntos
Embolia Pulmonar , Tromboembolia Venosa , Anticoagulantes/uso terapêutico , Medicina Baseada em Evidências , Humanos , América Latina/epidemiologia , Embolia Pulmonar/tratamento farmacológico , Tromboembolia Venosa/tratamento farmacológico
4.
Blood Adv ; 5(15): 3047-3052, 2021 08 10.
Artigo em Inglês | MEDLINE | ID: mdl-34374749

RESUMO

BACKGROUND: From 2017 to 2020, the American Society of Hematology (ASH) collaborated with 12 hematology societies in Latin America to adapt the ASH guidelines on venous thromboembolism (VTE). OBJECTIVE: To describe the methods used to adapt the ASH guidelines on venous thromboembolism. METHODS: Each society nominated 1 individual to serve on the guideline panel. The work of the panel was facilitated by the 2 methodologists. The methods team selected 4 of the original VTE guidelines for a first round. To select the most relevant questions, a 2-step prioritization process was conducted through an on-line survey and then through in-person discussion. During an in-person meeting in Rio de Janeiro, Brazil, from 23 April through 26 April 2018, the panel developed recommendations using the ADOLOPMENT approach. Evidence about health effects from the original guidelines was reused, but important data about resource use, accessibility, feasibility, and impact in health equity were added. RESULTS: In the guideline accompanying this paper, Latin American panelists selected 17 questions from an original pool of 49. Of the 17 questions addressed, substantial changes were introduced for 5 recommendations, and remarks were added or modified for 12 recommendations. CONCLUSIONS: By using the evidence from an international guideline, a significant amount of work and time were saved; by adding regional evidence, the final recommendations were tailored to the Latin American context. This experience offers an alternative to develop guidelines relevant to local contexts through a global collaboration.


Assuntos
Hematologia , Tromboembolia Venosa , Brasil , Medicina Baseada em Evidências , Humanos , América Latina/epidemiologia , Tromboembolia Venosa/tratamento farmacológico
5.
Nutrients ; 13(7)2021 Jul 14.
Artigo em Inglês | MEDLINE | ID: mdl-34371915

RESUMO

Poor health and diet quality are associated with living within a low socioeconomic status (SES). This study aimed to investigate the impact of SES on diet quality and body mass index in Latin America. Data from the "Latin American Health and Nutrition Study (ELANS)", a multi-country, population-based study of 9218 participants, were used. Dietary intake was collected through two 24 h recalls from participants of Argentina, Brazil, Chile, Colombia, Costa Rica, Ecuador, Peru and Venezuela. Diet quality was assessed using the dietary quality score (DQS), the dietary diversity score (DDS) and the nutrients adequacy ratio (NAR). Chi-squared and multivariate-variance analyses were used to estimate possible associations. We found that participants from the low SES consumed less fruits, vegetables, whole grains, fiber and fish and seafood and more legumes than those in the high SES. Also, the diet quality level, assessed by DQS, DDS and NAR mean, increased with SES. Women in the low SES also showed a larger prevalence of abdominal obesity and excess weight than those in the middle and high SES. Health policies and behavioral-change strategies should be addressed to reduce the impact of socioeconomic factors on diet quality and body weight, with gender as an additional level of vulnerability.


Assuntos
Índice de Massa Corporal , Dieta , Valor Nutritivo , Obesidade Abdominal/epidemiologia , Determinantes Sociais da Saúde , Fatores Socioeconômicos , Adolescente , Adulto , Idoso , Estudos Transversais , Dieta/efeitos adversos , Feminino , Humanos , América Latina/epidemiologia , Masculino , Pessoa de Meia-Idade , Inquéritos Nutricionais , Estado Nutricional , Obesidade Abdominal/diagnóstico , Prevalência , Medição de Risco , Fatores de Risco , Fatores Sexuais , Ganho de Peso , Adulto Jovem
6.
BMJ Open ; 11(8): e044920, 2021 08 02.
Artigo em Inglês | MEDLINE | ID: mdl-34341032

RESUMO

OBJECTIVE: We aimed to estimate the association between informal employment and mortality in Latin America and the Caribbean (LAC) by comparing welfare state regimes. DESIGN: Ecological study using time-series cross-sectional analysis of countries. Informality was estimated from household surveys by the Center for Distributive, Labor and Social Studies in collaboration with the World Bank, and the adult mortality rates for 2000-2016 were obtained from the WHO databases. Countries were grouped by welfare state regimes: state productivist, state protectionist and familialist. We calculated the compound annual growth rate for each country and performed linear regression between the informality and the adult mortality rates stratified by sex and welfare state regime. SETTING: Seventeen countries from LAC with available data on informality and adult mortality rates for 2000-2016. PRIMARY OUTCOME MEASURE: The association between informality and mortality by welfare state regime. RESULTS: Between 2000 and 2016, mortality rates decreased an average 1.3% per year and informal employment rates 0.5% per year. We found a significant positive association between informality and mortality rates (women: R2=0.48; men: R2=0.36). The association was stronger among the state regime countries (women: R2=0.58; men: R2=0.77), with no significant association among the familialist countries. CONCLUSION: Informal employment negatively impacts population health, which is modified by welfare state regimes. Addressing informal employment could be an effective way to improve population health in LAC. However, linkage with public health and labour market agendas will be necessary.


Assuntos
Emprego , Seguridade Social , Adulto , Região do Caribe , Estudos Transversais , Países em Desenvolvimento , Feminino , Humanos , América Latina/epidemiologia , Masculino
7.
BMJ Open ; 11(8): e047779, 2021 08 19.
Artigo em Inglês | MEDLINE | ID: mdl-34413102

RESUMO

OBJECTIVES: Latin America and the Caribbean (LAC) countries have made important progress towards achieving the Sustainable Development Goal (SDG) targets related to health (SDG3) at the national level. However, vast within-country health inequalities remain. We present a baseline of health inequalities in the region, against which progress towards the SDGs can be monitored. SETTING: We studied 21 countries in LAC using data from Demographic and Health Surveys and Multiple Indicator Cluster Survey carried out from 2011 to 2016 PARTICIPANTS: The surveys collect nationally representative data on women and children using multistage sampling. In total, 288 207 women and 195 092 children made part of the surveys in the 21 countries. OUTCOME MEASURES: Five health intervention indicators were studied, related to reproductive and maternal health, along with adolescent fertility and neonatal and under-five mortality rates. Inequalities in these indicators were assessed through absolute and relative measures. RESULTS: In most countries, subnational geographical health gradients were observed for nearly all women, child, and adolescent (WCA) indicators. Coverage of key interventions was higher in urban areas and among the richest, compared with rural areas and poorer quintiles. Analyses by woman's age showed that coverage was lower in adolescent girls than older women for family planning indicators. Pro-urban and pro-rich inequalities were also seen for mortality in most countries. CONCLUSIONS: Regional averages hide important health inequalities between countries, but national estimates hide still greater inequalities between subgroups of women, children and adolescents. To achieve the SDG3 targets and leave no one behind, it is essential to close health inequality gaps within as well as between countries.


Assuntos
Disparidades nos Níveis de Saúde , Desenvolvimento Sustentável , Adolescente , Idoso , Região do Caribe , Criança , Estudos Transversais , Feminino , Disparidades em Assistência à Saúde , Humanos , Recém-Nascido , América Latina/epidemiologia , Fatores Socioeconômicos
8.
BMJ Open ; 11(7): e050409, 2021 07 23.
Artigo em Inglês | MEDLINE | ID: mdl-34301665

RESUMO

OBJECTIVE: To estimate the pooled prevalence of multimorbidity (≥2 non-communicable diseases in the same individual) among adults of the general population of Latin American and the Caribbean (LAC). DESIGN: Systematic review and meta-analysis. DATA SOURCES: MEDLINE, Embase, Global Health, Scopus and LILACS up to 1 July 2020. ELIGIBILITY CRITERIA FOR SELECTING STUDIES: The outcome was the prevalence of multimorbidity. Reports were selected whether they enrolled adult individuals (age ≥18 years) from the general population. DATA EXTRACTION AND SYNTHESIS: Reviewers extracted relevant data and assessed risk of bias independently. A random-effects meta-analysis was conducted to report pooled prevalence estimates of multimorbidity; pooled estimates by pre-specified subgroups (eg, national studies) were also pursued. RESULTS: From 5830 results, we selected 28 reports, mostly from Brazil and 16 were based on a nationally representative sample. From the 28 selected reports, 26 were further included in the meta-analysis revealing a pooled multimorbidity prevalence of 43% (95% CI: 35% to 51%; I2: 99.9%). When only reports with a nationally representative sample were combined, the pooled prevalence was 37% (95% CI: 27% to 47%; I2: 99.9%). When the ascertainment of multimorbidity was based on self-reports alone, the pooled prevalence was 40% (95% CI: 31% to 48%; I2: 99.9%); this raised to 52% (95% CI: 33% to 70%; I2: 99.9%) for reports including self-reported and objective diagnosis. CONCLUSIONS: Our results complement and advance those from global efforts by incorporating much more reports from LAC. We revealed a larger presence of multimorbidity in LAC than previously reported. PROSPERO REGISTRATION NUMBER: CRD42020196177.


Assuntos
Multimorbidade , Adolescente , Brasil , Região do Caribe , Humanos , América Latina/epidemiologia , Prevalência
10.
Arch Osteoporos ; 16(1): 114, 2021 07 24.
Artigo em Inglês | MEDLINE | ID: mdl-34302550

RESUMO

The Latin American Federation of Endocrinology position statement on osteoporosis was developed by endocrinologists from 9 countries. It encompasses the definition, diagnosis, treatment, and follow-up of the disease, the identification of barriers to healthcare, and proposals to improve the disease care in the region. INTRODUCTION: There is a gap in the understanding of osteoporosis in Latin America. The objective of this work is to state the position of the Latin American Federation of Endocrinology on osteoporosis care in postmenopausal women to better bridge this gap. METHODS: An experts' panel was formed comprising of 11 endocrinologists from 9 countries. A data search was conducted with a conceptual approach and data selection was based on the hierarchy of the EBHC pyramid. Unpublished data was considered for local epidemiological data and expert opinion for the identification of barriers to healthcare. An expert consensus based on the Delphi methodology was carried out. Experts were asked to respond on a 5-point Likert Scale to two provided answers to guiding questions. RESULTS: Consensus was agreed on the answer for the questions with the higher median on the Likert scale and synthetized on 16 statements covering the definition of osteoporosis, diagnostic approach, treatment options, and follow-up. Besides clinical topics, unmet needs in osteoporosis were identified in relation to local epidemiological data, barriers to treatment, and misclassification of programs within health systems. CONCLUSIONS: Through a process based on recognized methodological tools, FELAEN's position on osteoporosis was developed. This made it possible to state an optimum scenario for the care of the disease and helped to identify knowledge gaps. There is great variability in the approach to osteoporosis in Latin America and barriers in all the stages of healthcare persist.


Assuntos
Osteoporose , Consenso , Feminino , Seguimentos , Humanos , América Latina/epidemiologia , Osteoporose/diagnóstico , Osteoporose/epidemiologia , Osteoporose/terapia
11.
Artigo em Inglês | MEDLINE | ID: mdl-34281007

RESUMO

The COVID-19 pandemic affected the relationship between work and life almost everywhere on the planet. Suddenly, remote work became the mainstream way of working for millions of workers. In this context, we explore how the relationship between remote work, work stress, and work-life developed during pandemic times in a Latin America context. In a sample of 1285 responses collected between April and May 2020, through a PLS-SEM model, we found that remote work in pandemic times increased perceived stress (ß = 0.269; p < 0.01), reduced work-life balance (ß = -0.225; p < 0.01) and work satisfaction (ß = -0.190; p < 0.01), and increased productivity (ß = 0.120; p < 0.01) and engagement (ß = 0.120; p < 0.01). We also found a partial moderating effect, competitive and complementary, of perceived stress, and one significant gender difference: when working remotely, perceived stress affects men's productivity more acutely than women's productivity.


Assuntos
COVID-19 , Pandemias , Feminino , Humanos , América Latina/epidemiologia , Masculino , SARS-CoV-2 , Equilíbrio Trabalho-Vida
12.
Cad Saude Publica ; 37(6): e00322320, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34231763

RESUMO

The COVID-19 pandemic may accentuate existing problems, hindering access to legal abortion, with a consequent increase in unsafe abortions. This scenario may be even worse in low- and middle-income countries, especially in Latin America, where abortion laws are already restrictive and access to services is already hampered. Our objective was to understand how different countries, with an emphasis on Latin Americans, have dealt with legal abortion services in the context of the COVID-19. Thus, we conducted a narrative review on abortion and COVID-19. The 75 articles included, plus other relevant references, indicate that the pandemic affects sexual and reproductive health services by amplifying existing problems and restricting access to reproductive rights, such as legal abortion. This impact may be even stronger in low- and middle-income countries, especially in Latin America, where access to legal abortion is normally restricted. The revision of sources in this article underlines the urgent need to maintain legal abortion services, both from women's perspective, in support of their reproductive rights, but also from that of the international commitment to achieving the Millennium Development Goals. Thereby, Latin American countries must place reproductive rights as a priority on their agendas and adapt legislation to accommodate alternative models of abortion care. Furthermore, our results underscore the need for clear information on the functioning of sexual and reproductive health services as essential for understanding the impact of the pandemic on legal abortion and to identify the groups most affected by the changes.


Assuntos
Aborto Induzido , COVID-19 , Aborto Legal , Brasil , Países em Desenvolvimento , Feminino , Humanos , América Latina/epidemiologia , Pandemias , Gravidez , SARS-CoV-2
13.
Cien Saude Colet ; 26(7): 2575-2586, 2021 Jul.
Artigo em Português, Inglês | MEDLINE | ID: mdl-34231671

RESUMO

Health Promotion (HP) has recently been strengthened within public policies and still shows strong consonance with international determinations regarding childhood and adolescence in Latin America (LA). Debating HP becomes all the more urgent considering the increasing prevalence of psychological distress in this age group and the historical political construction of Latin American countries. This research aimed to identify and analyze, through an integrative review of the literature, the academic productions on strategies for mental HP of adolescents in LA and, thus, to visualize the actions and arouse reflections dialoguing with the Southern critics, represented by the Bogotá declaration. Six studies were selected after applying the inclusion and exclusion criteria. We identified that the main space where actions are developed is the school. The potential measures identified were professional training, group action, and strengthening primary and territorial care. We discussed that the historically structured socioeconomic reality of LA reflects an organization of HP actions. Furthermore, the visualization of strategies that enhance at low cost the improved mental health of adolescents can contribute to the current reflection.


Assuntos
Promoção da Saúde , Saúde Mental , Adolescente , Criança , Hispano-Americanos , Humanos , América Latina/epidemiologia
14.
Arq Bras Oftalmol ; 84(4): 339-344, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34287515

RESUMO

PURPOSE: To assess the perception of Latin American ophthalmology practitioners regarding coronavirus disease 2019 (COVID-19) exposure risk, knowledge about personal protection measures, and prioritization of patients. METHODS: Self-administered voluntary anonymous survey (Google Drive forms) was distributed via text message to ophthalmology practitioners from May 01 to May 05, 2020. RESULTS: Three hundred seventy-one practitioners (45% response rate) comprising 118 (27.6%) residents, 111 (40.5%) ophthalmologists, and 142 (32.8%) sub-specialists completed the survey. Among them, 106 (32.6%) thought that they were at a high risk of acquiring COVID-19 during the course of work. Furthermore, 273 (69.1%) believed that the current guidelines were insufficient to identify COVID-19 patients. The survey also revealed that 265 (59.5%) were not trained to use personal protective equipment (PPE), and even with its correct use, 341 (91.5%) still felt that they were at risk of acquiring COVID-19. Moreover, 80% of the respondents were of the view that staff members were not knowledgeable about national protocols for attending COVID-19 patients. However, only 9 (2%) considered changing their profession to ameliorate COVID-19 contagion risk. CONCLUSION: This survey has revealed the issues faced by ophthalmology practitioners in Latin America during their routine practice. These concerns and anxiety about COVID- 19 pandemic seem to be the same worldwide. It is important to reinforce the confidence of ophthalmology practitioners on current guidelines for attending COVID-19 patients. It is also necessary to conduct training programs on PPE usage and ensure that PPE items are available at all times to enhance the quality of care and minimize the spread of the disease.


Assuntos
COVID-19 , Oftalmologia , Humanos , América Latina/epidemiologia , Pandemias/prevenção & controle , Percepção , SARS-CoV-2 , Inquéritos e Questionários
15.
Artigo em Inglês | MEDLINE | ID: mdl-34199070

RESUMO

The pandemic caused by COVID-19 has left millions infected and dead around the world, with Latin America being one of the most affected areas. In this work, we have sought to determine, by means of a multiple regression analysis and a study of correlations, the influence of population density, life expectancy, and proportion of the population in vulnerable employment, together with GDP per capita, on the mortality rate due to COVID-19 in Latin American countries. The results indicated that countries with higher population density had lower numbers of deaths. Population in vulnerable employment and GDP showed a positive influence, while life expectancy did not appear to significantly affect the number of COVID-19 deaths. In addition, the influence of these variables on the number of confirmed cases of COVID-19 was analyzed. It can be concluded that the lack of resources can be a major burden for the vulnerable population in combating COVID-19 and that population density can ensure better designed institutions and quality infrastructure to achieve social distancing and, together with effective measures, lower death rates.


Assuntos
COVID-19 , Países em Desenvolvimento , Humanos , Incidência , América Latina/epidemiologia , Mortalidade , Dinâmica Populacional , SARS-CoV-2 , Fatores Socioeconômicos
16.
Artigo em Inglês | MEDLINE | ID: mdl-34206907

RESUMO

The population's behavioral responses to containment and precautionary measures during the COVID-19 pandemic have played a fundamental role in controlling the contagion. A comparative analysis of precautionary behaviors in the region was carried out. A total of 1184 people from Mexico, Colombia, Chile, Cuba, and Guatemala participated through an online survey containing a questionnaire on sociodemographic factors, precautionary behaviors, information about COVID-19, concerns, maintenance of confinement, and medical symptoms associated with COVID-19. Cubans reported the highest scores for information about COVID-19. Colombians reported less frequent usage of precautionary measures (e.g., use of masks), but greater adherence to confinement recommendations in general, in contrast to the low levels of these behaviors in Guatemalans. Chileans reported greater pandemic-related concerns and the highest number of medical symptoms associated with COVID-19. These findings allow a partial characterization of the Latin American population's responses during the second and third phases of the COVID-19 pandemic and highlight the importance of designing and managing public health policies according to the circumstances of each population when facing pandemics.


Assuntos
COVID-19 , Pandemias , Chile/epidemiologia , Colômbia , Guatemala/epidemiologia , Humanos , América Latina/epidemiologia , México , SARS-CoV-2
17.
JCO Glob Oncol ; 7: 1151-1166, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34270330

RESUMO

PURPOSE: Adult T-cell leukemia/lymphoma (ATLL) is an aggressive disease caused by the human T-cell leukemia virus type 1. Real-world data of ATLL in Latin America are lacking. PATIENTS AND METHODS: We analyzed patients with ATLL (acute, lymphomatous, chronic, and smoldering) encountered in 11 Latin American countries between 1995 and 2019. Treatment response was assessed according to the 2009 consensus report. Survival curves were estimated using the Kaplan-Meier method and log-rank test. RESULTS: We identified 253 patients; 226 (lymphomatous: n = 122, acute: n = 73, chronic: n = 26, and smoldering: n = 5) had sufficient data for analysis (median age 57 years). Most patients with ATLL were from Peru (63%), Chile (17%), Argentina (8%), and Colombia (7%). Hypercalcemia was positively associated with acute type (57% v lymphomatous 27%, P = .014). The median survival times (months) were 4.3, 7.9, 21.1, and not reached for acute, lymphomatous, chronic, and smoldering forms, with 4-year survival rates of 8%, 22%, 40%, and 80%, respectively. First-line zidovudine (AZT)-interferon alfa (IFN) resulted in an overall response rate of 63% (complete response [CR] 24%) for acute. First-line chemotherapy yielded an overall response rate of 41% (CR 29%) for lymphomatous. CR rate was 42% for etoposide, cyclophosphamide, vincristine, doxorubicin, and prednisone versus 12% for cyclophosphamide, vincristine, doxorubicin, and prednisone-like regimen (P < .001). Progression-free survival at 1 year for acute type patients treated with AZT-IFN was 67%, whereas 2-year progression-free survival in lymphomatous type patients who achieved CR after chemotherapy was 77%. CONCLUSION: This study confirms Latin American ATLL presents at a younger age and has a high incidence of lymphomatous type, low incidence of indolent subtypes, and worse survival rates as compared with Japanese patients. In aggressive ATLL, chemotherapy remains the preferred choice for lymphomatous favoring etoposide-based regimen (etoposide, cyclophosphamide, vincristine, doxorubicin, and prednisone), whereas AZT-IFN remains a good first-line option for acute subtype.


Assuntos
Leucemia-Linfoma de Células T do Adulto , Linfoma , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Argentina , Chile , Colômbia , Humanos , América Latina/epidemiologia , Leucemia-Linfoma de Células T do Adulto/tratamento farmacológico , Leucemia-Linfoma de Células T do Adulto/epidemiologia , Pessoa de Meia-Idade , Peru/epidemiologia
18.
Braz Oral Res ; 35(suppl 01): e052, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34076076

RESUMO

Robust epidemiological data allow for logical interventions taken in the interest of public health. Dental caries is a major public health problem driven by increased sugar consumption and various biological, behavioral, and psychosocial factors, and is known to strongly affect an individual's quality of life. This study aims to critically review epidemiological data on the prevalence of dental caries in Latin American and Caribbean countries (LACC) and its impact on the oral health-related quality of life (OHRQoL) of the population. Although the majority of national surveys did not include all age groups and several countries reported a reduction in the prevalence of cavitated carious lesions, most nations still exhibited a high burden of decayed teeth. OHRQoL evaluation was limited to children and older adults only, and was not included in any national survey. Study heterogeneity and methodological issues hindered comparison of evidence between studies and over time, and updating national level data on caries prevalence and its impact on OHRQoL should be prioritized in LACCs.


Assuntos
Cárie Dentária , Qualidade de Vida , Idoso , Região do Caribe/epidemiologia , Criança , Estudos Transversais , Cárie Dentária/epidemiologia , Humanos , América Latina/epidemiologia , Saúde Bucal , Prevalência
19.
Braz Oral Res ; 35(suppl 01): e056, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34076080

RESUMO

Dental caries can be effectively managed and prevented from developing into cavitated lesions while preserving tooth structure at all levels. However, the strong correlation between caries and socioeconomic factors may compromise the efficacy of preventive strategies. The high prevalence of persistent inequalities in dental caries in Latin American and Caribbean countries (LACC) is a matter of concern. The estimates of the burden of disease in some countries in this region are outdated or absent. This paper aims to summarize and present the final recommendations of a regional Consensus for Dental Caries Prevalence, Prospects, and Challenges for LACC. This consensus is based on four articles that were written by a team of Latin American experts, reviewed by dental associations, and presented and discussed in two consensus events. The following domains were explored: epidemiology, risk factors, prevention strategies, and management of dental caries with a focus on restorative procedures. Dental caries can manifest throughout the lifespan of an individual, making it a matter of concern for infants, children, adults, and older people alike. The prevalence rates of untreated caries in deciduous and permanent teeth are high in many parts of the world, including LACCs. Previous evidence suggests that the prevalence of dental caries in 12-year-olds is moderate to high in most Latin American countries. Moreover, the prevalence of treatment needs and dental caries in the adult and elderly population can also be regarded as high in this region. The risk/protective factors (e.g., sugar consumption, exposure to fluoride, and oral hygiene) probably operate similarly in all LACCs, although variations in the interplay of these factors in some countries and within the same country cannot be ruled out. Although salt and water fluoridation programs are implemented in many countries, there is a need for implementation of a surveillance policy. There is also room for improvement with regard to the introduction of minimal intervention techniques in practice and public health programs. Dental caries is a marker of social disadvantage, and oral health promotion programs and interventions aimed at reducing the burden of dental caries in LACCs must consider the complexity of the socioeconomic dynamics in this region. There is an urgent need to promote engagement of stakeholders, policymakers, medical personnel, universities, dental associations, community members, and industries to develop regional plans that enhance the oral health agenda for LACCs. A list of recommendations has been presented to underpin strategies aimed at reducing the prevalence and severity of dental caries and improving the quality of life of the impacted LACC population in the near future.


Assuntos
Cárie Dentária , Adulto , Idoso , Região do Caribe , Criança , Consenso , Cárie Dentária/epidemiologia , Cárie Dentária/prevenção & controle , Humanos , Lactente , América Latina/epidemiologia , Prevalência , Qualidade de Vida
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