Suboptimal response to tumor necrosis factor antagonists in inflammatory bowel disease in Latin America: EXPLORE LATAM study.

OBJECTIVE: Data on anti-tumor necrosis factor (anti-TNF) treatment and suboptimal response (SOR) among patients with inflammatory bowel diseases (IBD) in Latin America (LATAM) are scarce. This study evaluated the incidence and indicators of SOR to anti-TNF therapy in patients with ulcerative colitis (UC) and Crohn's disease (CD) from Argentina, Colombia and Mexico. PATIENTS AND METHODS: We performed retrospective analysis of data from LATAM patients of the EXPLORE study (NCT03090139) including adult patients with IBD who initiated anti-TNF therapy between March 2010 to March 2015. The cumulative incidence of SOR to first-line anti-TNF therapy was assessed. A physician survey to assess barriers to anti-TNF therapies was also carried out. RESULTS: We included 185 IBD patients (UC/CD: 99/86) treated with first-line anti-TNF from Argentina (38 UC; 40 CD), Colombia (21 UC; 25 CD) and Mexico (40 UC; 21 CD). 36.4% of patients with UC and 46.5% of patients with CD experienced SOR to anti-TNF therapy during the median (interquartile range) observational period: 49.0 months (37.2-60.1) in UC, and 50.0 months (40.9-60.1) in CD. The most common indicator of SOR among patients was augmentation of non-biologic therapy (UC: 41.7%; CD: 35.0%). Affordability and late referral to IBD specialist care centers were the most common barriers to anti-TNF therapies. CONCLUSIONS: SOR to anti-TNF therapy was common in LATAM IBD patients, where augmentation with non-biologic therapy represented the most frequent indicator of SOR across indications. Our findings contribute to the current evidence on the unmet needs associated with anti-TNF in LATAM.

Latin American Attachment studies: A narrative review.

Attachment theory´s core hypotheses (universality, normativity, sensitivity, and competence) are assumed to be applicable worldwide. However, the majority of studies on attachment theory have been conducted in Western countries, and the extent to which these core hypotheses are supported by research conducted in Latin America has never been systematically addressed. The purpose of this systematic narrative literature review is to provide an integrative discussion of the current body of empirical studies concerning attachment theory conducted in Latin American countries. For that purpose, a search was conducted in four electronic databases (Web of Science, PsycInfo, SciELO, and Redalyc) and 82 publications on attachment and/or sensitivity met inclusion criteria. None of the studies reported cases in which an attachment relationship was absent, and a predominance of secure attachment patterns was found, mainly for non-risk samples (NRS). Sensitivity levels were generally deemed adequate in NRS, and related to attachment quality. Attachment security and caregivers' sensitivity were positively associated with child outcomes. Attachment-based intervention studies mostly showed efficacy. In conclusion, Latin American research supports the key theoretical assumptions of attachment theory, mainly in samples of urban middle-class NRS. However, the field of attachment-related research would be enriched by also investing in Latin American studies on caregiving rooted in local concepts and theories.

What is post-COVID-19 syndrome? Definition and update.

This work addresses the origin and development of post-COVID-19 syndrome, which consists of the persistence of different symptoms over time as a consequence of SARS-CoV-2 infection. Based on a narrative review of the scientific literature, a brief analysis of the new term is made, specifying the conceptual definition, characteristic symptoms, the various implications for people's health, and the responses to specific care measures that have been implemented. It concludes with a wake-up call to the governments of Latin America and the Caribbean in order for care and surveillance to be provided to this public health problem.

Este trabajo aborda el origen y el desarrollo del síndrome pos-COVID-19, el cual consiste en la persistencia a través del tiempo de diferentes síntomas como consecuencia de la infección por SARS-CoV-2. A partir de una revisión narrativa de la literatura científica, se realiza un breve recorrido sobre el nuevo término y se precisa la definición conceptual, los síntomas característicos, las diversas implicaciones en la salud de las personas y las respuestas de atención específica que se han implementado. Se concluye con una llamada de atención a los gobiernos de América Latina y el Caribe para dar tratamiento y seguimiento a este problema de salud pública.

Synergies and trade-offs among integrated conservation approaches in Mexico.

Integrated conservation approaches (ICAs) are employed by governments, communities, and nongovernmental organizations worldwide seeking to achieve outcomes with dual benefits for biodiversity conservation and poverty alleviation. Although ICAs are frequently implemented concurrently, interactions among ICAs and the synergies or trade-offs that result are rarely considered during program design, implementation, and evaluation. In support of more deliberate and effective use of ICAs, we examined interactions among four well-known strategies: biosphere reserves (BRs), voluntary protected areas (VPAs), payments for ecosystem services (PES), and community forest management (CFM). Through a comparative case study, we analyzed interactions among spatially or temporally clustered ICAs implemented on communally held and managed lands in three ecologically and socioeconomically distinct regions of Mexico. Our research methods combined policy analysis with data gathered through participant observation and semistructured interviews (n = 78) and focus groups (n = 5) with government officials, implementers, and participants involved in ICAs in 28 communities. Despite the significant differences among the regions in which they were implemented, we found that key actors at each level of involvement generally perceived interactions among ICAs as synergistic. The PES programs were perceived to strengthen protected areas by reducing forest cover loss in and around BRs, fostering proconservation attitudes, and incentivizing the establishment of VPAs. Communities that invested PES income in CFM were motivated to conserve forests beyond the duration of PES programs, and CFM in buffer zones was perceived to strengthen BRs by maintaining forest cover and generating income for communities. We also identified key social and environmental factors that can influence these interaction effects among ICAs. Based on these findings, we recommend further study of ICA interactions and intentionally complementary policy design to maximize positive environmental and social outcomes.

Las estrategias de conservación integrada (ECI) son empleadas en todo el mundo por los gobiernos, comunidades y organizaciones no gubernamentales que buscan alcanzar resultados con beneficios tanto para la conservación como para la mitigación de la pobreza. A pesar de que múltiples ECI suelen implementarse simultáneamente, es raro que se tomen en cuenta las posibles interacciones positivas (sinergías) o negativas (trade-offs) durante el diseño, la implementación y la evaluación de estos programas. En búsqueda de un uso más deliberado y efectivo de las ECI, examinamos las interacciones entre cuatro estrategias conocidas: reservas de la biósfera (RB), áreas protegidas voluntarias (APV), pagos por servicios ambientales (PSA) y el manejo comunitario de los bosques (MCB). Mediante un estudio de caso comparativo analizamos las interacciones entre las ECI agrupadas espacial o temporalmente implementadas en tierras con administración y propiedad comunal en tres regiones con diferencias ecológicas y socioeconómicas en México. Nuestros métodos de investigación combinaron el análisis de políticas con datos recopilados mediante la observación participativa, entrevistas semiestructuradas (n = 78) y grupos focales (n = 5) con funcionarios del gobierno, implementadores y participantes involucrados en las ECI de 28 comunidades. A pesar de las diferencias significativas entre las regiones en las que se implementaron estas ECI, descubrimos que los actores clave en cada nivel de participación percibieron de manera generalizada las interacciones entre las ECI como sinérgicas. Los programas de PSA fueron percibidos como algo que fortalece a las áreas protegidas mediante la reducción de la pérdida de la cobertura forestal dentro y fuera de las RB, el fomento de las actitudes a favor de la conservación y el estímulo al establecimiento de las APV. Las comunidades que invirtieron los ingresos por PSA en el MCB expresaron su motivación para conservar los bosques más allá de la duración de los programas de PSA y el MCB en zonas de amortiguamiento fue percibido como un factor de fortalecimiento de las RB mediante el mantenimiento de la cobertura forestal y la generación de ingresos para las comunidades. También identificamos los factores sociales y ambientales importantes que pueden influir sobre estos efectos de interacción entre las ECI. Con base en estos hallazgos, recomendamos un estudio más profundo de las interacciones entre las ECI y un diseño de políticas intencionalmente complementario para maximizar los resultados sociales y ambientales positivos.

Changes in chronic idiopathic ulcerative colitis epidemiological pattern in Mexico in a tertiary care hospital.

BACKGROUND: Chronic idiopathic ulcerative colitis (CIUC) is a disease with multifactorial chronic inflammation of the colonic mucosa. Its prevalence ranges from 37.5-250/100,000 in North America to 10-500/100,000 in Europe. In Mexico, there are studies that show an increase in the frequency of new cases. The purpose of this work was to identify possible changes in CIUC behavior in a referral hospital. METHODS: New ulcerative colitis (UC) cases confirmed by histopathology from January 2007 to December 2014 were included. Clinical and demographic data were collected through the review of medical records and direct interview in order to compare them with a previous study conducted at the same institution from January 1986 to December 2006. RESULTS: A total of 189 patients were included. Mean number of UC annual new cases was 23.6. The study included 95 male patients (50 %) and 94 female patients (50 %), with an average age of 44.6 years at diagnosis. The frequency of pancolitis was 77 %, in comparison with 59 % in the previous period. Extra-intestinal manifestations (EIM) were present in 55.8 % and colectomies in 5.2 %. CONCLUSION: There is a lower mean of annual new cases; however, some characteristics of the disease have changed over time: there is an increased frequency of pancolitis and EIM, as well as a decrease in the rate of colectomies.

ANTECEDENTES: La colitis ulcerosa crónica idiopática (CUCI) es una enfermedad con inflamación crónica de la mucosa del colon de origen multifactorial. El objetivo de este trabajo es identificar posibles cambios en el comportamiento de la CUCI en un hospital de referencia. MÉTODOS: Se incluyeron nuevos casos de CUCI confirmados por histopatología de enero del 2007 a diciembre del 2014. RESULTADOS: Se incluyeron un total de 189 pacientes. La media de nuevos casos anuales de CUCI fue de 23.6. Este estudio incorpora 95 pacientes de sexo masculino (50 %) y 94 de sexo femenino (50 %), con una edad promedio al diagnóstico de 44.6 años. La frecuencia de pancolitis fue del 77 %, en comparación con el 59 % en el periodo anterior. Las manifestaciones extraintestinales (MEI) estuvieron presentes en el 55.8 % y las colectomías en el 5.2 %. CONCLUSIÓN: Algunas características de la enfermedad han cambiado con el tiempo: aumento de la frecuencia de pancolitis y MEI, así como disminución de la tasa de colectomías.

[Knowledge, access and use of the health system by migrant adolescents in Chile: results of an exploratory study]. / Conocimiento, acceso y uso del sistema de salud en adolescentes migrantes en Chile: resultados de un estudio exploratorio.

OBJECTIVE: To identify the knowledge, access, and use of the health system by migrant adolescents, and the barriers to access and use of the health system in that population in Chile. METHODS: Observational, cross-sectional exploratory study applied in a participatory workshop with migrant adolescents (N=30) in three municipalities of the city of Santiago, Chile. Multimethods study. A baseline survey on the migration process and experiences in the health system was applied, with descriptive data analysis. From the qualitative point of view, discussion groups (n=5) and participatory workshops (n=2) were carried out with migrant adolescents. RESULTS: Sixty percent of the adolescents said they did not know if they were registered in the health system, and half of them had not used it. Time of residence was identified as a relevant factor for the effective use of some health benefits. Administrative barriers to access the health system were recognized, such as immigration status, perception of obligatory adult companionship, and experiences of discrimination in care. Specific needs were identified in sexual and reproductive health, such as access to condoms, and mental health care from specialists. As facilitators of access and use, experiences of proper treatment and the presence of the health sector in schools were highlighted. CONCLUSIONS: Lack of information about the health system and various barriers to access and use by migrant adolescents were identified. Based on the results, general recommendations are proposed for the country and the region to improve the health of migrant adolescents.

Current scenario of plasmid-mediated colistin resistance in Latin America.

Colistin resistance can occur by chromosomal mutations and by acquisition of plasmid-carrying determinants, mainly mcr-1. In the recent years, we have observed the outburst of this resistance gene in our region. Due to the risk of the rapid dissemination of mcr-1, this finding has worried and alerted different actors from the health field and has become one of the most prolific topics. Our review compiles available reports of well-documented mcr-1-positive strains of Enterobacteriaceae, obtained from different samples in Argentina and other countries of Latin America. Furthermore, it addresses the association of mcr-1 with ESBL resistance markers and outlines the platforms involved in their dissemination.

Carbapenemases in Acinetobacter baumannii. Review of their dissemination in Latin America.

Carbapenem resistance in gram-negative bacteria by production of carbapenemases is one of the most challenging issues regarding healthcare worldwide. We review the epidemiology and prevalence of carbapenemases in carbapenem-resistant Acinetobacter baumannii isolates from Latin American countries. High resistance rates to antimicrobial agents, particularly to carbapenems, are observed in this region. OXA-23 is the most widely disseminated class D-carbapenemase; it is present in all the countries of the region and is frequently associated to endemic clones CC113/CC79, CC104/CC15, CC110/ST25 and CC109/CC1. The emergence of OXA-72 and NDM-1 represents a novel finding which is observed simultaneously and without clonal relatedness in different countries, some of which are distant from one another, whereas OXA-143 is only present in Brazil. Further collaborative intraregional studies would provide a better understanding of these issues in most of the countries and thus, policies to control the spread of these isolates could be implemented.

Evaluación, prevención y tratamiento de MARSI en América latina: reporte del JWC Masterclass.

RESUMEN: El 13 de julio de 2022, el Journal of Wound Care LATAM (JWC LATAM) presentó su primer Masterclass. Esta clase magistral fue transmitida en vivo, en formato de webinar. Contó con la participación de tres ponentes que abarcaron definición, causas, factores de riesgo y clasificación de MARSI. Describieron, también, cómo determinar quiénes están en riesgo de desarrollar MARSI, qué cuidados tener en cuenta para reducir el riesgo de este tipo de heridas, cuán desarrollado está el concepto de MARSI en América latina, y qué dice la literatura acerca de las mejores prácticas. El siguiente reporte resume los puntos más relevantes. CONFLICTO DE INTERÉS: Ninguno.

Evaluación, prevención y tratamiento de MARSI en América latina: reporte del JWC Masterclass.

RESUMEN: El 13 de julio de 2022, el Journal of Wound Care LATAM (JWC LATAM) presentó su primer Masterclass. Esta clase magistral fue transmitida en vivo, en formato de webinar. Contó con la participación de tres ponentes que abarcaron definición, causas, factores de riesgo y clasificación de MARSI. Describieron, también, cómo determinar quiénes están en riesgo de desarrollar MARSI, qué cuidados tener en cuenta para reducir el riesgo de este tipo de heridas, cuán desarrollado está el concepto de MARSI en América latina, y qué dice la literatura acerca de las mejores prácticas. El siguiente reporte resume los puntos más relevantes. CONFLICTO DE INTERÉS: Ninguno.

Clinical guidelines for Western clinicians engaged in primary care medical service trips in Latin America and the Caribbean: an integrative literature review.

OBJECTIVE: Participation in primary care-focused medical service trips (MSTs) by North American providers is increasingly common, with many of these being conducted in Latin America. The literature has yet to comprehensively explore the nature of MST practice, including the use of evidence-based clinical guidelines. This integrative review presents an analysis of guidelines employed in MSTs in Latin America. METHODS: MEDLINE and LILACs were searched using the terms 'medical brigades', 'Latin America', 'primary health care' and related terms. The search was limited to articles published between 2000 and 2015 in any language. Qualitative or quantitative articles were subsequently included if they described management protocols in the context of patient care on an MST occurring in Latin America. Additional publications were identified by searching the citations of articles reviewed in full. Themes were extracted to an Excel file, and objective instruments were used to evaluate article quality (Mixed Methods Assessment Tool) and the quality of guidelines (Appraisal of Guidelines for Research & Evaluation II). RESULTS: Of 391 abstracts screened, eight met inclusion criteria. All described MSTs operating in rural settings in Central America. Five were qualitative descriptive, including two travel reports, an ethics thesis paper, and a description of a dermatologic MST. Four described subjective clinician experiences while describing non-evidence-based treatment suggestions or practices. Only one described evidence-supported primary care interventions. Three studies were quantitative descriptive, including two epidemiological articles, one of which used case definitions for select diagnoses. One described the application of American Family Physician guidelines to the description of UTI prevalence on a MST. Article scores in MMAT quality domains were variable, and only one article achieved a positive overall AGREE II score for guideline quality. CONCLUSIONS: Existing literature demonstrates minimal development or use of clinical guidelines on MSTs in Latin America. Future work must focus on the development, implementation, and evaluation of culturally sensitive, evidence-based guidelines for the management of patients receiving care from MSTs.

[Migrations in Latin American countries. Characteristics of the pediatric population]. / Migraciones en países de América Latina. Características de la población pediátrica.

INTRODUCTION: Migration is a growing phenomenon among Latin American countries (LAC) as well as others; however, scarce information is available studying its impact on paediatric groups and its association with socioeconomic variables. OBJECTIVE: To study the association among socioeconomic variables and the immigration rate of paediatric population in LAC. MATERIAL AND METHODS: Official rates of migration of LAC were obtained from: International Organization for Migration, Pan American Health Organization, and United Nations Development Programme. Demographic and socioeconomic information was also obtained for: gross domestic product (GDP), human development index (HDI), Gini coefficient of inequality (GC), alphabetization rate for adults (AA), net migration rate (NMR), and immigration of children<15 years (IM15). Description, linear correlations and analysis of differences between groups of countries were assessed. RESULTS: The NMR was positive for Costa Rica, Panama, Venezuela, Chile and Argentina. No association among NMR and GDP, HDI, GC, AA was found. A correlation of IM15 was found with: GC (r=0.668, P=.01), with GDP (r=-0.720; P=.01), AA (r=-0.755; P=.01) and with HDI (r=-0.799; P=.01). Rate of IM15 was lower in LA countries with advanced/medium development (GDP>median) vs those with low development (Fisher, P<.0001). CONCLUSIONS: There is a direct inverse association between GDP per capita, HDI, AA and GC and the proportion of each country IN15. We did not observe an association between NMR and HDI, AA, and GC. The health impact of these migrations should be analysed.

De la epidemiología de la actividad física a la epidemiología crítica de las prácticas corporales: una propuesta desde Latinoamérica.

This essay aims to analyze the epidemiology of physical activity as a practical and epistemological field in dispute, based on the theoretical framework of international critical epidemiology. From this scientific point of view, the epidemiology of physical activity is radically marked by epistemological-health colonialism. This brand is expressed in the theoretical-practical distance from critical epidemiological thinking formulated in the global south, producing an artificial regional dependency and deep frustration in those who want to generate transformations in contemporary ways of living. It is suggested that a critical epidemiology of body practices is possible and necessary. In other words, the epidemiology developed in the countries of Latin America and the Caribbean can dialectically understand the determination, distribution and social reproduction of the phenomenon of bodily practices, since it resumes its critical formulations and intercultural science.

[Primary health care: challenges for implementation in Latin America]. / La Atención Primaria de Salud: desafíos para su implementación en América Latina.

A development process, marked by the re-appearance of the primary health care as the core of health systems, has emerged in Latin America. Governments have made a commitment to renew this strategy as the basis of their health systems. However, these health systems are mainly faced with re-introducing equity values, and there are common challenges such as providing the health systems with trained human resources in sufficient numbers, overcoming the fragmentation/segmentation of the systems, ensuring financial sustainability, improving governance, quality of care and information systems, expanding coverage, preparing to face the consequences of an aging population, the changing epidemiological profile, and increase in the response capacity of the public health system. This article is intended to provide a comprehensive view of the progress and challenges of the inclusion of primary care health systems in Latin American countries.

Gender network analysis of the Eating Disorder Examination-Questionnaire (EDE-Q7) in Peruvian adults.

Introduction: Background: network assessment of eating disorder (ED)-related symptomatology from a gender perspective is an important topic of study; however, there is limited research in the Latin American context. Objective: this study aimed to explore the patterns of association of the components of the Eating Disorder Examination-Questionnaire (EDE-Q7) according to gender, using two simultaneous network models in 890 Peruvian adults (63.51 % were women; mean age: 26.40). Methods: two graphs considering the gender factor were made using the R package qgrap and the merged LASSO graph. Results: higher network centrality measures were obtained for items related to body image dissatisfaction and overvaluation in women; while in the men's network, the items of food restriction and overestimation of weight were the most central symptoms. Conclusion: both network models were invariant and showed no significant differences in both structure and connections.

Introducción: Introducción: la evaluación de redes de la sintomatología relacionada con los trastornos alimentarios (TA) desde el punto de vista del género es un tema importante de estudio; sin embargo, existen pocas investigaciones en el contexto latinoamericano. Objetivo: el objetivo de este estudio fue explorar los patrones de asociación de los componentes del Eating Disorder Examination-Questionnaire (EDE-Q7) según el sexo mediante dos modelos de red simultánea en 890 adultos peruanos (63,51 % de mujeres; edad promedio: 26,40 años). Métodos: se realizaron dos gráficos considerando el factor género utilizando el paquete R qgrap y el gráfico LASSO fusionado. Resultados: se obtuvieron medidas de centralidad de red más altas para los ítems relacionados con la insatisfacción y la sobrevaloración de la imagen corporal en las mujeres; mientras que, en la red de los hombres, los ítems de restricción alimentaria y sobrevaloración del peso eran los síntomas más centrales. Conclusión: ambos modelos de red resultaron invariables y no mostraron diferencias significativas a nivel de estructura y conexiones.

Trajectories of Cancer Care in Latin America: A Scope Review: Trayectorias de atención al cáncer en América Latina. Una revisión de alcance.

OBJECTIVES: In recent decades there has been a development of research on cancer care trajectories in Latin America; however, the diversity of theoretical-methodological uses of this approach can be confusing and difficult for the academic and professional community to use. To analyze studies that have been carried out in Latin America on cancer care trajectories to propose a typology of the approaches developed and synthesize key findings. METHODS: A scope review of studies published in journals indexed in PubMed, LILACS, and SciELO databases in the period 2006-2021 was conducted. RESULTS: 22 articles were analyzed. A typology of descriptive, evaluative, and interpretative approaches was proposed. From the key findings, the following were identified: the importance of pleasure and the feeling of power in the development of risky practices; the role of popular explanatory models for the identification of abnormality and the search for attention; the interaction of various personal, interpersonal, organizational, and structural barriers that limited timely diagnosis and continuity of treatment; the sequential or parallel use of different forms of care, public and private; and the importance of social support networks. CONCLUSIONS: The proposed typology clarifies the different uses of the approach. The informative synthesis evidences problematic knots regarding multiple barriers to access and allows us to propose as priorities in future research the study of types of cancer, stages, and populations that have been scarcely addressed, as well as the diversification of methodological approaches.

Behçet disease in Latin American countries: A systematic literature review of demographic and clinical features, and HLA-B*51 allele frequency.

OBJECTIVE: To describe the demographic and clinical features, as well as the frequency of the HLA-B*51 allele in Behçet disease (BD) patients in Latin American countries. METHODS: A systematic literature review of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analysis) guidelines was conducted without performing a meta-analysis. We included observational studies (cross-sectional or cohort) of BD patients fulfilling the International Study Group for BD classification criteria and reported the demographic, clinical, and laboratory features of the disease in adult patients. RESULTS: Twelve studies were included in the SLR. Information from 532 patients across 5 Latin American countries was included for the analysis. Mean age at disease diagnosis was 33 years, 58.3% were female and 41.7% male; most patients were non-Caucasian. The most common clinical manifestations were recurrent oral ulcers and genital ulcers, followed by skin, eye, joint, neurological, gastrointestinal, vascular, and cardiac involvement. The prevalence of BD was described in 2 studies, 1 conducted in Brazil that reported a prevalence of .3/100,000 inhabitants, and another in Colombia with a prevalence of 1.1/100,000 inhabitants. The frequency of HLA-B*51 allele in BD patients was 38%, 30.1%, and 9% in Argentina, Brazil, and Mexico, respectively. CONCLUSIONS: The prevalence of BD in the Latin American countries seems to be low, as well as the frequency of HLA-B*51 allele. However, the strength of association between HLA-B*51 and BD remains high in our population. The key clinical features of BD are like those reported in countries/regions where BD is endemic.

A Cross-sectional Study of the Mental Health Symptoms of Latin American, US Hispanic, and Spanish College Students Amid the COVID-19 Pandemic.

Young adults and racial/ethnic minorities report the worst mental health outcomes during the COVID19 pandemic, according to the Center for Disease Control (2020). The objectives of this study were (1) to identify common mental health symptoms among Latin American, US Hispanic, and Spanish college students, and (2) to identify clinical features predictive of higher post-traumatic stress symptoms (PTSS) among this population. The study sample included 1,113 college students from the USA, Mexico, Chile, Ecuador, and Spain who completed an online survey containing demographic questions and mental health screeners. Findings revealed higher scores of depression, suicidality, and PTSS compared to pre-pandemic levels and current scores by non-Spanish speaking college students; however, less than 5% of participants endorsed clinical levels of anxiety. After controlling for demographic profiles and sociocultural values, clinical symptoms of depression, loneliness, perceived stress, anxiety, and coping strategies explained 62% of the PTSS variance. Age, history of mental illness, perceived social support, and familism were not significant predictors. This sample of college students revealed higher mental health symptoms during the COVID-19 pandemic. The high prevalence of PTSS highlights the need to develop pragmatic, cost-effective, and culturally sensitive prevention and intervention strategies to mitigate these symptoms. Implications for college administrators and clinicians are discussed.

Gender differences in cardiology professionals: A Latin American Survey.

BACKGROUND: Gender-based differences among cardiology professionals have been reported in North America and Europe. However, the perspective of Latin American cardiologists remains unexplored. OBJECTIVES: The objectives of the study were to analyze the gender gap perspective among cardiologists from Latin America. METHODS: A cross-sectional study using an online survey directed to Latin American cardiologists from five different cardiology societies. The survey included questions on demographic data, professional development in the field of cardiology, and perceived barriers in clinical practice. RESULTS: A total of 240 professionals were surveyed, of which 41.7% were women (100) and 58.3% were men (140). The majority of women tend to work in the subfields of clinical cardiology and cardiovascular imaging. Women were underrepresented as heads of departments, earn less, and report less work satisfaction than men. The barriers that female cardiologists face at their workplace include labor discrimination, sexual harassment, family-related concerns, and lack of career development. CONCLUSIONS: The survey points toward the prevalence of a gender gap among cardiologists in Latin America, which is primarily driven by labor discrimination, sexual harassment, family-related concerns, and lack of career development among female cardiologists. Actions aimed at addressing this issue should be considered by different parties.

ANTECEDENTES: Existen diferencias de género entre los profesionales en cardiología en Europa y Norteamérica. La perspectiva de este suceso en América Latina permanece inexplorado. OBJECTIVOS: Analizar la perspectiva de la diferencia de género entre cardiólogos en América Latina. METODOS: Estudio transversal en el que se usó un cuestionario en línea dirigido a profesionales en cardiología en América Latina. El cuestionario incluía datos demográficos, desarrollo profesional en el campo de la campo de la cardiología y la percepción de las barreras en la práctica clínica. RESULTADOS: un total de 240 profesionales fueron analizados, de los cuales 41.7% (100) fueron mujeres y 58.3% (140) fueron hombres. La mayoría de las mujeres suelen trabajar en el área de imagen cardiovascular. Se encontró subrepresentación del género femenino en jefaturas de departamento, tienen un menor salario y reportan menor satisfacción laboral en comparación con los hombres. Las barreas que enfrentan en su lugar de trabajo fueron discriminación laboral, acoso sexual y falta de desarrollo profesional. CONCLUSIONES: El cuestionario señala la prevalencia de la diferencia de género en América Latina, principalmente por discriminación laboral, acoso sexual y falta de desarrollo profesional. Se necesita tomar acciones interinstitucionales que vayan dirigidas a reducir y eliminar esta brecha.

Magnet ingestion knows no borders: A threat for Latin American children.

INTRODUCTION AND AIMS: The ingestion of foreign bodies, such as magnets, is a potentially lethal accident that affects children and is associated with bleeding and gastrointestinal perforation, as well as death. There are no Latin American reports in the literature on cases of magnet ingestion in children. Our aim was to establish whether said ingestion has been seen by pediatric endoscopists and gastroenterologists in Latin America, to determine the scope of that potential threat in their patient populations. MATERIALS AND METHODS: We collected data regarding endoscopies performed on children in Latin America, within the time frame of 2017-2019, through questionnaires that were distributed to pediatric endoscopists at the 2nd World Congress of Gastrointestinal Endoscopy (ENDO 2020). The questionnaires provided information on foreign body location, the presence and number of ingested magnets, and the description of complications and surgical interventions. RESULTS: Our cohort from 12 Latin American countries reported 2,363 endoscopies due to foreign body ingestion, 25 (1.05%) of which were the result of having swallowed one or more magnets. Mean patient age was 5.14 years (SD 2.5) and 10 (40%) of the cases were girls. Three (12%) of the patients presented with severe complications and 2 (8%) cases required surgery. CONCLUSIONS: Our preliminary study suggests that the ingestion of magnets is not common in Latin American countries, but said cases are frequently associated with complications. Constant monitoring of the incidence of such cases is extremely important, so that through education and awareness of those events, life-threatening complications in children can be prevented.