Repositório Institucional - Unifesp :: Navegando por Palavras-chave "Latin America"

Navegando por Palavras-chave "Latin America"

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Active Surveillance of Candidemia in Children from Latin America A Key Requirement for Improving Disease Outcome
(Lippincott Williams & Wilkins, 2014-02-01) Santolaya, Maria E.; Alvarado, Tito; Queiroz-Telles, Flavio; Colombo, Arnaldo L. [UNIFESP]; Zurita, Jeanette; Tiraboschi, Iris N.; Alberto Cortes, Jorge; Thompson, Luis; Guzman, Manuel; Sifuentes, Jose; Echevarria, Juan I.; Nucci, Marcio; Latin Amer Invasive Mycosis Networ; Univ Chile; Hosp Escuela Tegucigalpa; Univ Fed Parana; Universidade Federal de São Paulo (UNIFESP); Pontificia Univ Catolica Ecuador; Hosp Clin Jose San Martin; Univ Nacl Colombia; Univ Desarrollo; Hosp Vargas Caracas; Inst Nacl Ciencias Med & Nutr Salvador Zubiran; Univ Cayetano Heredia; Universidade Federal do Rio de Janeiro (UFRJ)
Background: Active surveillance is necessary for improving the management and outcomes of patients with candidemia. the aim of this study was to describe the epidemiologic and clinical features of candidemia in pediatric patients in Latin America.Method: Prospective, multicenter, surveillance study of candidemia in a pediatric population from 23 hospitals in 8 Latin America countries between November 2008 and October 2010.Results: Three hundred and two cases of candidemia were reported with a median incidence of 0.81/1000 admissions. Eighty nine (29%) were neonates. the main risk factors were prematurity, intensive care unit (ICU) admission, parenteral nutrition, respiratory disease and mechanical ventilation in neonates and malignancy, neutropenia, neurological disease and previous use of corticosteroids in children. the main species isolated in neonates and children were Candida albicans (43.8% and 35.7%), Candida parapsilosis (27.0% and 26.3%) and Candida tropicalis (14.6% and 14.6%), respectively. the most frequent antifungal therapy used in neonates and children was deoxycholate-amphotericin-B (43.8% and 29.1%) and fluconazole (28.1% and 53.1%). Seventeen neonates (19.1%) and 20 children (9.4%) did not receive antifungal therapy. the 30-day survival rate was 60% in neonates and 72% in children (P = 0.02). Survival was significantly higher in treated than in nontreated neonates (72% vs. 24%; P < 0.001). A multivariate analysis showed that independent predictors for 30-day mortality in children were renal disease (odds ratio: 4.38, 95% confidence interval: 1.92-10.1, P < 0.001) and receipt of corticosteroids (odds ratio: 2.08, 95% confidence interval: 1.04-4.17, P = 0.04).Conclusions: To our knowledge, this is the first prospective, multicenter surveillance study of candidemia in children in Latin America. This epidemiologic information may provide us with methods to improve preventive, diagnostic and therapeutic strategies in our continent.
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Advancing the management of primary immunodeficiency diseases in Latin America: Latin American Society for Immunodeficiencies (LASID) Initiatives
(Elsevier B.V., 2012-05-01) Condino-Neto, A.; Franco, J. L.; Espinosa-Rosales, F. J.; Leiva, L. E.; King, A.; Porras, O.; Oleastro, M.; Bezrodnik, L.; Grumach, A. S.; Costa-Carvalho, B. T. [UNIFESP]; Sorensen, R. U.; Universidade de São Paulo (USP); Univ Antioquia; Inst Nacl Pediat; Lousiana State Univ Hlth Sci Ctr; Hosp Ninos Luis Calvo Mackenna; Hosp Nacl Ninos Dr Carlos Saenz Herrera; Hosp Nacl Pediat Prof Dr Juan P Garrahan; Hosp Ninos Dr Ricardo Gutierrez; Fac Med ABC; Ctr Dis Control Immunizat; Universidade Federal de São Paulo (UNIFESP); Univ La Frontera
Primary immunodeficiency diseases (PIDD) are associated with significant morbidity and mortality and result in a significant public health burden. This is in part due to the lack of appropriate diagnosis and treatment of these patients. It is critical that governments become aware of this problem and provide necessary resources to reduce this impact on health care systems. Leading physicians in their respective countries must be supported by their own governments in order to implement tools and provide education and thus improve the diagnosis and treatment of PIDD. the Latin American Society of Primary Immunodeficiencies (LASID) has initiated a large number of activities aimed at achieving these goals, including the establishment of a PIDD registry, development of educational programmes and guidelines, and the introduction of a PIDD fellowship programme. These initiatives are positively impacting the identification and appropriate treatment of patients with PIDD in Latin America. Nevertheless, much remains to be done to ensure that every person with PIDD receives proper therapy. (C) 2011 SEICAP. Published by Elsevier Espana, S.L. All rights reserved.
Acesso aberto (Open Access)
Alcohol and violence in the emergency department: a regional report from the WHO collaborative study on alcohol and injuries
(Inst Nacional Salud Publica, 2008-01-01) Borges, Guilherme; Orozco, Ricardo; Cremonte, Mariana; Buzi-Figlie, Neliana [UNIFESP]; Cherpitel, Cheryl; Poznyak, Vladimir; Inst Nacl Psiquiatria; Univ Autonoma Metropolitana; Univ Nacl Mar del Plata; Universidade Federal de São Paulo (UNIFESP); Inst Publ Hlth; WHO
Objective. To determine the relative risk (RR) of non-fatal unintentional and violence-related injury associated with alcohol consumption in three emergency departments in Latin America (2001-2002). Material and Methods. Pair-matched case-crossover was used to obtain RR estimates for alcohol in non-fatal injuries among 447 patients in Argentina (A), 489 in Brazil (B) and 455 in Mexico (M). Intentional (violence) or unintentional (non-violence) injury status were the main outcomes Results. About 46% of violence-related cases involved alcohol (versus 11.5% for non-violence related cases). The risk of violence-related injury increased with drinking and had an OR = 15.0 (95% confidence interval (CI), 5.8-39.1), with an OR = 4.2 (CI = 2.7-6.5) for unintentional injuries. Conclusions. Increasing amounts of drinking may have pronounced consequences on the risk of triggering an injury, especially for a violence-related injury. The RR estimates provided here can be useful for new estimates on alcohol and the burden of disease.
Acesso aberto (Open Access)
Antimicrobial activity of dalbavancin tested against Gram-positive clinical isolates from Latin American medical centres
(Blackwell Publishing Ltd, 2005-02-01) Gales, Ana Cristina [UNIFESP]; Sader, Helio Silva [UNIFESP]; Jones, Ronald N. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); JONES Grp; Tufts Univ
The activity of dalbavancin, a new semi-synthetic lipoglycopeptide antibiotic, was evaluated in comparison with other antibacterial agents against 1229 Gram-positive organisms collected from medical centres in Latin America. Dalbavancin was the most potent compound tested against isolates of Staphylococcus aureus (MIC50, 0.06 mg/L) and coagulase-negative staphylococci (MIC50, 0.03 mg/L), independently of methicillin susceptibility. Dalbavancin inhibited all Streptococcus pneumoniae isolates at less than or equal to 0.06 mg/L. Dalbavancin also demonstrated excellent activity against beta-haemolytic (MIC50, less than or equal to 0.008 mg/L) and viridans group (MIC50, 0.016 mg/L) streptococci. All vancomycin-susceptible Enterococcus spp. isolates were inhibited by dalbavancin at less than or equal to 0.25 mg/L, but some vancomycin-resistant Enterococcus spp. isolates were only inhibited by dalbavancin levels of greater than or equal to 8 mg/L. Dalbavancin exhibited excellent activity against isolates of Corynebacterium spp. and Listeria spp. Dalbavancin may provide an important therapeutic option for Gram-positive infections, excluding those caused by enterococci with VanA-type resistance.
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Antimicrobial susceptibility of Streptococcus pneumoniae in Latin America: results from five years of the SENTRY Antimicrobial Surveillance Program
(Blackwell Publishing Ltd, 2004-07-01) Castanheira, Mariana [UNIFESP]; Gales, Ana Cristina [UNIFESP]; Mendes, Rodrigo Elisandro [UNIFESP]; Jones, R. N.; Sader, Helio Silva [UNIFESP]; Jones Grp; Universidade Federal de São Paulo (UNIFESP)
A total of 1561 pneumococcal isolates were collected in 1997-2001, mainly from patients with community-acquired respiratory tract infections, and susceptibilities were tested by reference broth microdilution against 29 antimicrobial agents. in general, 69.3% of strains were considered susceptible (MIC less than or equal to 0.06 mg/L) to penicillin. Resistance to penicillin (MIC greater than or equal to 2 mg/L) and cefotaxime (MIC greater than or equal to 4 mg/L) was found in 11.9% and 0.4% of isolates, respectively. the fluoroquinolones gatifloxacin (MIC90, 0.5 mg/L) and levofloxacin (MIC90, 1 mg/L) were active against > 99% of the isolates tested. Among the other non-beta-lactam drugs tested, the rank order of susceptibility was chloramphenicol (95.6%) > clindamycin (94.5%) > azithromycin (88.5%) > clarithromycin (87.5%) >tetracycline (79.5%) > trimethoprim + sulphamethoxazole (60.5%). the penicillin-non-susceptible isolates presented higher rates of resistance to other antimicrobial agents. the rank order of penicillin resistance rates among the seven participating countries was Mexico (25.0%) > Uruguay (19.2%) > Chile (18.3%) > Colombia = Argentina (9.9%) > Brazil (3.9%) > Venezuela (2.8%). the regional rate of penicillin resistance did not vary significantly over the years studied (p 0.339). Screening for the ermB and mefA genes by multiplex rapid cycle PCR on 23 erythromycin-resistant isolates collected during the year 2001 showed that 43.5% and 56.5%, respectively, were positive for ermB and mefA. Overall, the results indicated that antimicrobial susceptibilities of Streptococcus pneumoniae vary significantly among Latin American countries. Regional and local surveillance programmes are necessary to guide empirical therapy of pneumococcal infection in Latin American countries.
Acesso aberto (Open Access)
Antimicrobial susceptibility patterns of unusual nonfermentative gram-negative bacilli isolated from Latin America: report from the SENTRY Antimicrobial Surveillance Program (1997-2002)
(Instituto Oswaldo Cruz, Ministério da Saúde, 2005-10-01) Gales, Ana Cristina [UNIFESP]; Jones, Ronald N; Andrade, Soraya Sgambatti [UNIFESP]; Sader, Helio Silva [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); JMI Laboratories The Jones Group
The antimicrobial susceptibility of 176 unusual non-fermentative gram-negative bacilli (NF-GNB) collected from Latin America region through the SENTRY Program between 1997 and 2002 was evaluated by broth microdilution according to the National Committee for Clinical Laboratory Standards (NCCLS) recommendations. Nearly 74% of the NF-BGN belonged to the following genera/species: Burkholderia spp. (83), Achromobacter spp. (25), Ralstonia pickettii (16), Alcaligenes spp. (12), and Cryseobacterium spp. (12). Generally, trimethoprim/sulfamethoxazole (MIC50, < 0.5 µg/ml) was the most potent drug followed by levofloxacin (MIC50, 0.5 µg/ml), and gatifloxacin (MIC50, 1 µg/ml). The highest susceptibility rates were observed for levofloxacin (78.3%), gatifloxacin (75.6%), and meropenem (72.6%). Ceftazidime (MIC50, 4 µg/ml; 83.1% susceptible) was the most active beta-lactam against B. cepacia. Against Achromobacter spp. isolates, meropenem (MIC50, 0.25 µg/ml; 88% susceptible) was more active than imipenem (MIC50, 2 µg/ml). Cefepime (MIC50, 2 µg/ml; 81.3% susceptible), and imipenem (MIC50, 2 µg/ml; 81.3% susceptible) were more active than ceftazidime (MIC50, >16 µg/ml; 18.8% susceptible) and meropenem (MIC50, 8 µg/ml; 50% susceptible) against Ralstonia pickettii. Since selection of the most appropriate antimicrobial agents for testing and reporting has not been established by the NCCLS for many of NF-GNB species, results from large multicenter studies may help to guide the best empiric therapy.
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Assembling the Puzzle for Promoting Physical Activity in Brazil: A Social Network Analysis
(Human Kinetics Publ Inc, 2010-07-01) Brownson, Ross C.; Parra, Diana C.; Dauti, Marsela; Harris, Jenine K.; Hallal, Pedro C.; Hoehner, Christine; Malta, Deborah Carvalho; Reis, Rodrigo S.; Ramos, Luiz Roberto [UNIFESP]; Ribeiro, Isabela C.; Soares, Jesus; Pratt, Michael; Washington Univ; St Louis Univ; Univ Fed Pelotas; Brazil Minist Hlth; Pontificia Univ Catolica Parana; Univ Fed Parana; Universidade Federal de São Paulo (UNIFESP); Ctr Dis Control & Prevent
Background: Physical inactivity is a significant public health problem in Brazil that may be addressed by partnerships and networks. In conjunction with Project GUIA (Guide for Useful Interventions for Physical Activity in Brazil and Latin America), the aim of this study was to conduct a social network analysis of physical activity in Brazil. Methods: An online survey was completed by 28 of 35 organizations contacted from December 2008 through March 2009. Network analytic methods examined measures of collaboration, importance, leadership, and attributes of the respondent and organization. Results: Leadership nominations for organizations studied ranged from 0 to 23. Positive predictors of collaboration included: south region, GUIA membership, years working in physical activity, and research, education, and promotion/practice areas of physical activity. The most frequently reported barrier to collaboration was bureaucracy. Conclusion: Social network analysis identified factors that are likely to improve collaboration among organizations in Brazil.
Acesso aberto (Open Access)
Uma 'biblioteca sem paredes': história da criação da Bireme
(Casa de Oswaldo Cruz, Fundação Oswaldo Cruz, 2006-03-01) Silva, Márcia Regina Barros da [UNIFESP]; Ferla, Luis Antonio Coelho [UNIFESP]; Gallian, Dante Marcello Claramonte [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); FAAP
Approaching from the framework of social, political, and economic contexts, the article analyzes the process involved in creation of the Latin American and Caribbean Center on Health Sciences Information (Bireme). The period in question coincides with the consolidation of US influence in the West, between the 1950s and 1970s. A recovery and examination of reference documents and testimonies permits a discussion of the issues involved in setting up what was first known as the Regional Library of Medicine, an initiative in cultural and scientific integration that was highly influential in Latin American health sciences. The article offers reflections on the historical development of the institution as an initiative of the Pan American Health Organization and its subsequent role.
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Challenges in the diagnosis and management of acromegaly: a focus on comorbidities
(Springer, 2016) Abreu, Alin; Pinzon Tovar, Alejandro; Castellanos, Rafael; Valenzuela, Alex; Gomez Giraldo, Claudia Milena; Castellanos Pinedo, Alejandro; Pantoja Guerrero, Doly; Builes Barrera, Carlos Alfonso; Ignacio Franco, Humberto; Ribeiro-Oliveira, Antonio, Jr.; Vilar, Lucio; Jallad, Raquel S.; Duarte, Felipe Gaia; Gadelha, Monica; Boguszewski, Cesar Luiz; Abucham, Julio [UNIFESP]; Naves, Luciana A.; Musolino, Nina Rosa C.; Justamante de Faria, Maria Estela; Rossato, Ciliana; Bronstein, Marcello D.
Acromegaly is a rare, insidious disease resulting from the overproduction of growth hormone (GH) and insulin-like growth factor 1 (IGF-1), and is associated with a range of comorbidities. The extent of associated complications and mortality risk is related to length of exposure to the excess GH and IGF-1, thus early diagnosis and treatment is imperative. Unfortunately, acromegaly is often diagnosed late, when patients already have a wide range of comorbidities. The presence of comorbid conditions contributes significantly to patient morbidity/mortality and impaired quality of life. We conducted a retrospective literature review for information relating to the diagnosis of acromegaly, and its associated comorbidities using PubMed. The main aim of this review is to highlight the issues of comorbidities in acromegaly, and to reinforce the importance of early diagnosis and treatment. Successful management of acromegaly goes beyond treating the disease itself, since many patients are diagnosed late in disease evolution, they present with a range of comorbid conditions, such as cardiovascular disease, diabetes, hypertension, and sleep apnea. It is important that patients are screened carefully at diagnosis (and thereafter), for common associated complications, and that biochemical control does not become the only treatment goal. Mortality and morbidities in acromegaly can be reduced successfully if patients are treated using a multimodal approach with comprehensive comorbidity management.
Acesso aberto (Open Access)
Challenges to reduce the '10/90 gap': mental health research in Latin American and Caribbean countries
(Wiley-Blackwell, 2008-12-01) Razzouk, D. [UNIFESP]; Gallo, C.; Olifson, S.; Zorzetto, R. [UNIFESP]; Fiestas, F.; Poletti, G.; Mazzotti, G.; Levav, I.; Mari, J. J. [UNIFESP]; Universidade Federal de São Paulo (UNIFESP); Univ Peruana Cayetano Heredia; Global Forum Hlth Res; Minist Hlth
To analyze the status of mental health research in 30 Latin American and Caribbean countries (LAC).Medline and PsycInfo databases were searched to identify the LAC authors. Their publications were classified according to the topic, type of research and target population studied. Scientific indicators of these countries were assessed in other two different databases: Essential Scientific Information and Atlas of Science Project, both from Institute for Scientific Information.Indexed-publications were concentrated in six countries: Argentina, Brazil, Chile, Colombia, Mexico and Venezuela. Most studies dealt with the burdensome mental disorders but neglected important topics such as violence and other mental health priorities.Mental health research is mostly concentrated in a few LAC countries, but these countries would contribute to reduce the research gap, if they provide research training to their neighbors and engage in bi- or multi-lateral research collaboration on common region priorities.
Acesso aberto (Open Access)
Characterization of individuals at high risk of developing melanoma in Latin America: bases for genetic counseling in melanoma
(Nature Publishing Group, 2016) Puig, Susana; Potrony, Miriam; Cuellar, Francisco; Puig-Butille, Joan Anton; Carrera, Cristina; Aguilera, Paula; Nagore, Eduardo; Garcia-Casado, Zaida; Requena, Celia; Kumar, Rajiv; Landman, Gilles [UNIFESP]; Soares de Sa, Bianca Costa; Rezze, Gisele Gargantini; Facure, Luciana; Ribeiro de Avila, Alexandre Leon; Achatz, Maria Isabel; Carraro, Dirce Maria; Duprat Neto, Joao Pedreira; Grazziotin, Thais C.; Bonamigo, Renan R.; Rey, Maria Carolina W.; Balestrini, Claudia; Morales, Enrique; Molgo, Montserrat; Bakos, Renato Marchiori; Ashton-Prolla, Patricia; Giugliani, Roberto; Borges, Alejandra Larre; Barquet, Virginia; Perez, Javiera; Martinez, Miguel; Cabo, Horacio; Sabban, Emilia Cohen; Latorre, Clara; Carlos-Ortega, Blanca; Salas-Alanis, Julio C.; Gonzalez, Roger; Olazaran, Zulema; Malvehy, Josep; Badenas, Celia
Purpose: CDKN2A is the main high-risk melanoma-susceptibility gene, but it has been poorly assessed in Latin America. We sought to analyze CDKN2A and MC1R in patients from Latin America with familial and sporadic multiple primary melanoma (SMP) and compare the data with those for patients from Spain to establish bases for melanoma genetic counseling in Latin America. Methods: CDKN2A and MC1R were sequenced in 186 Latin American patients from Argentina, Brazil, Chile, Mexico, and Uruguay, and in 904 Spanish patients. Clinical and phenotypic data were obtained. Results: Overall, 24 and 14% of melanoma-prone families in Latin America and Spain, respectively, had mutations in CDKN2A. Latin American families had CDKN2A mutations more frequently (P = 0.014) than Spanish ones. Of patients with SMP, 10% of those from Latin America and 8.5% of those from Spain had mutations in CDKN2A (P = 0.623). The most recurrent CDKN2A mutations were c.-34G>T and p.G101W. Latin American patients had fairer hair (P = 0.016) and skin (P < 0.001) and a higher prevalence of MC1R variants (P = 0.003) compared with Spanish patients. Conclusion: The inclusion criteria for genetic counseling of melanoma in Latin America may be the same criteria used in Spain, as suggested in areas with low to medium incidence, SMP with at least two melanomas, or families with at least two cases among first-or second-degree relatives.
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Child mental health in Latin America: present and future epidemiologic research
(Baywood Publ Co Inc, 2003-01-01) Duarte, Cristiane [UNIFESP]; Hoven, Christina; Berganza, Carlos; Bordin, Isabel [UNIFESP]; Bird, Hector; Miranda, Claudio T.; Universidade Federal de São Paulo (UNIFESP); Columbia Univ
Objective: This report reviews population studies of child and adolescent mental health carried out in Latin America over the past 15 years. Also considered is the issue of how to meet the needs of children and adolescents who may present mental health problems in Latin America, given that most of them live in poverty in economies that are underdeveloped, providing limited resources. Method: Ten studies from six different countries were identified that employed some form of randomized sampling method and used standardized instruments for assessment. the authors present a summary of the main characteristics of these studies, highlighting methodological features that may account for differences in the rates obtained. Results: Overall, a similar pattern of prevalence and risk factors for mental health problems in children and adolescents in Latin American countries emerged. Moreover, rates of disorders in these children are similar to the 15 to 20% found in other countries. These findings are similar to those observed when adult mental health problems are considered. Prevention and treatment strategies are discussed and the peculiarities of the delivery of mental health services for children and adolescents are explored. Conclusions: Future research needs to focus on understanding of resilience and formal and informal mental health delivery systems of care available in different Latin American countries. Such research has high potential for ameliorating the prevention and treatment of child and adolescent mental health problems in this region of the world.
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Cinema e Terceiro-mundismo: Luz Vermelha sobre a América Latina
(Universidade Federal de São Paulo (UNIFESP), 2010) Ferreira, Luís Gustavo Pereira [UNIFESP]; Villaça, Mariana Martins [UNIFESP]; http://lattes.cnpq.br/9020046743817649; http://lattes.cnpq.br/3451386421216468; Universidade Federal de São Paulo (UNIFESP)
I reviewed the film The red light bandit, Rogerio Sganzerla (1968), believing that this film raises questions relevant to the study of third-world-ism, political thought that seeks to break with what would be the delay of the classical division into one of the world and 3rd world, adhering to the theories of decolonization and national liberation, from the classic division into three worlds .. The film was loosely inspired by the true story of John Acacio Pereira da Costa, and chronicles the path of Light, the villain, character angry, but unable to turn their anger into productive reaction. Glauber Rocha's conceptions that influenced the Cinema Novo was inspired by Frantz Fanon, mainly in two aspects: definition of colonialism as violence and the process of decolonization as a total transformation behavior and structure of the colonized. These ideas were developed in his text Aesthetics of Hunger. Influenced by Fanon, Glauber extended the concept of New Cinema and formulated a project of "political integration and aesthetics of cinematography in poor countries on three continents (Latin America, Africa and Asia), this project called Tricontinental Film, inspired by the revolutionary internationalism guevariano. The red light bandit establishes a close relationship (albeit critical), with the production of Glauber Rocha, a Brazilian filmmaker closer to the Nuevo Cine Latinoamericano, and whose work argued forcefully the third-world-ism and colonialism, politics and the arts. The film has several elements that we consider representative of what might be called underdevelopment, which makes us see in it a work of art within this context of artistic production and intellectual engaged in processes of resistance U.S. imperialism. The discussion about the identity was also a concern of the Cinema Novo Glauberianism and several other Latin American filmmakers. In the bandit's identity and situation of Brazil are discussed in the Latin American panorama, which is part of a broader framework, the third world. As the announcers say in the movie, nobody knows the identity of the villain. Similarly, Brazilians and Latin Americans also do not have clarity about its identity. Returning several analysis of Brazil, such as those made by the modernists of the 20s, by the left and the New Cinema, Sganzerla made a film that talks also identified with the film production to third-world-ism and the aesthetics of cinema and Orson Welles Nouvelle Vague. Thus, the villain is an ironic film as it explores Latin American identity, Third World, and quite critical of the hegemonic ideological models in political cinema of the time.
Acesso aberto (Open Access)
Collaborative multicenter trials in Latin America: challenges and opportunities in orthopedic and trauma surgery
(Associacao Paulista Medicina, 2013-01-01) Moraes, Vinicius Ynoe de [UNIFESP]; Belloti, Joao Carlos [UNIFESP]; Faloppa, Flavio [UNIFESP]; Bhandari, Mohit; Universidade Federal de São Paulo (UNIFESP); McMaster Univ
CONTEXT and OBJECTIVE: Orthopedic research agendas should be considered from a worldwide perspective. Efforts should be planned as the means for obtaining evidence that is valid for health promotion with global outreach.DESIGN and SETTING: Exploratory study conducted at Universidade Federal de São Paulo (Unifesp), São Paulo, Brazil, and McMaster University, Hamilton, Canada.METHODS: We identified and analyzed collaborative and multicenter research in Latin America, taking into account American and Canadian efforts as the reference points. We explored aspects of the data available from official sources and used data from traffic accidents as a model for discussing collaborative research in these countries.RESULTS: the evaluation showed that the proportion of collaborative and multicenter studies in our setting is small. A brief analysis showed that the death rate due to traffic accidents is very high. Thus, it seems clear to us that initiatives involving collaborative studies are important for defining and better understanding the patterns of injuries resulting from orthopedic trauma and the forms of treatment. Orthopedic research may be an important tool for bringing together orthopedic surgeons, researchers and medical societies for joint action.CONCLUSIONS: We have indicated some practical guidelines for initiatives in collaborative research and have proposed some solutions with a summarized plan of action for conducting evidence-based research involving orthopedic trauma.
Acesso aberto (Open Access)
A comparative reassessment of regional parliaments in Latin America: Parlasur, Parlandino and Parlatino
(Inst Brasileiro Relacoes Int, 2017) Mariano, Karina Pasquariello; Bressan, Regiane Nitsch [UNIFESP]; Luciano, Bruno Theodoro
The present article assesses and compares the MERCOSUR Parliament, the Andean Parliament, and the Latin American Parliament as instruments to insert political representation and parliamentarians in their respective integration projects. It is argued that the development of regional parliaments in Latin America, however, has not produced substantial changes in regional decision-making processes, which remain the exclusive domain of intergovernmental or interpresidential exchanges.
Acesso aberto (Open Access)
A contribuição dos estudos transculturais dos países latino-americanos e caribenhos para a revisão da CID-10: resultados preliminares
(Associação Brasileira de Psiquiatria - ABP, 2011-05-01) Razzouk, Denise [UNIFESP]; Nogueira, Bruno [UNIFESP]; Mari, Jair de Jesus [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
OBJECTIVE: This review aims to verify the scientific evidences for the inclusion of culture bound syndromes in the International Classification of Diseases towards its 11th edition based on studies from Latin American and Caribbean countries. METHOD: Studies were identified in Medline, LILACS and EMBASE databases for the period between 1992 and 2008, and then classified according to the type of study, to the mental disorder, country and number of publications per year. RESULTS: 163 studies were selected and classified: 33 in MedlLne, 90 in EMBASE e 40 in LILACS. The percentage of culture bound-syndrome corresponded to 9% in Medline, 12% in EMBASE e 2.5% in LILACS. Among fifteen studies on cultural bound syndromes, two were about nervios and ataque de nervios, two about susto, four about the relationship between religion beliefs, witchery, trance and mental disorders, one with a proposal for new diagnostic category, three about theoretic issues and three about the pathoplasty of mental disorders. CONCLUSION: The scarcity of studies on culture bound syndromes might be due to the indexation problems hindering the screening of studies; lack of interest on publishing such studies in indexed journals (publication bias) and due to difficulty to access them. There is no robust evidence identified among cross-cultural studies to recommend changes for International Classification of Diseases-11th edition.
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Critical, issues and needs in management of primary immunodeficiency diseases in Latin America
(Elsevier B.V., 2011-01-01) Condino-Neto, A.; Franco, J. L.; Trujillo-Vargas, C.; Espinosa-Rosales, F. J.; Leiva, L. E.; Rodriguez-Quiroz, F.; King, A.; Lagos, M.; Oleastro, M.; Bezrodnik, L.; Grumach, A. S.; Costa-Carvalho, B. T. [UNIFESP]; Sorensen, R. U.; Universidade de São Paulo (USP); Univ Antioquia; Inst Nacl Pediat; LSU Hlth Sci Ctr; Hosp Especialidades Ctr Med La Raza; Hosp Ninos Luis Calvo Mackenna; Univ Valparaiso; Hosp Nacl Pediat Prof Dr Juan P Garrahan; Hosp Ninos Dr Ricardo Gutierrez; Universidade Federal de São Paulo (UNIFESP)
Experts from six Latin American countries met to discuss critical issues and needs in the diagnosis and management of primary immunodeficiency diseases (PIDD). the diagnosis of PIDD is generally made following referral to an immunology centre located in a major city, but many paediatricians and general practitioners are not sufficiently trained to suspect PIDD in the first place. Access to laboratory testing is generally limited, and only some screening tests are typically covered by government health programmes. Specialised diagnostic tests are generally not reimbursed. Access to treatment varies by country reflecting differences in healthcare systems and reimbursement policies. An online PIDD Registry Programme for Latin America has been available since 2009, which will provide information about PIDD epidemiology in the region. Additional collaboration across countries appears feasible in at least two areas: a laboratory network to facilitate the diagnosis of PIDD, and educational programmes to improve PIDD awareness. in total, these collaborations should make it possible to advance the diagnosis and management of PIDD in Latin America. (C) 2010 SEICAP. Published by Elsevier Espana, S.L. All rights reserved.
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Demographic Characteristics and Clinical Outcomes in Patients from Latin America Versus the Rest of the World: A TIOSPIR (R) Post-Hoc Analysis
(Elsevier Doyma Sl, 2018) Anzueto, Antonio; Calverley, Peter M. A.; Mueller, Achim; Metzdorf, Norbert; Haensel, Michaela; Jardim, José Roberto [UNIFESP]; Pizzichini, Emilio; Giraldo, Horacio; Ramirez-Venegas, Alejandra; Giugno, Eduardo R.
Introduction: Geographical variations may impact outcomes in chronic obstructive pulmonary disease (COPD). We evaluated differences in baseline characteristics and outcomes between patients enrolled in Latin America compared with the rest of the world (RoW) in the TIOtropium Safety and Performance In Respimat (R) (TIOSPIR (R)) trial. Methods: TIOSPIR (R), a 2-3-year, randomized, double-blind trial (n = 17 116
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Dissemination and diversity of metallo-beta-lactamases in Latin America: report from the SENTRY Antimicrobial Surveillance Program
(Elsevier B.V., 2005-01-01) Sader, Helio Silva [UNIFESP]; Castanheira, Mariana [UNIFESP]; Mendes, Rodrigo Elisandro [UNIFESP]; Toleman, Mark; Walsh, Thimoty R.; Jones, Ronald N.; JONES Grp; Universidade Federal de São Paulo (UNIFESP); Univ Bristol
Carbapenem resistance among Pseudomonas aeruginosa and Acinetobacter spp. is becoming a critical therapeutic problem worldwide. the SENTRY Antimicrobial Surveillance Program monitors pathogen frequency and antimicrobial resistance patterns of nosocomial and community-acquired infections through sentinel hospitals on five continents. Pseudomonas spp. and Acinetobacter Spp. strains resistant to imipenem (MIC, greater than or equal to 16 mg/l), meropenem (MIC, greater than or equal to 16 mg/l), and ceftazidime (MIC. greater than or equal to32 mg/l) collected from January 2001 to December 2003 were routinely screened for antimicrobial resistance genes. Resistant isolates were initially tested for metallo-beta-lactamase (MbetaL) production by phenotypic tests (disk approximation or MbetaL Etest strip) and then characterization of the MbetaL (hydrolysis assays, PCR for bla(IMP). bla(VIM), bla(SPM) gene sequencing). Eighty-nine isolates (33 Acinetobacter spp., 54 Pseudomonas aeruginosa. and 2 P. fluorescens) had positive phenotypic screening tests. Among those, 34 isolates producing MbetaL were identified, including 7 Acinetobacter spp., 25 P aeruginosa and 2 R fluorescens. the MbetaLs identified were IMP-1. VIM-2 and two newly described enzymes: SPM-1 and IMP-16. the greatest concentration of MOL strains was in Brazil, where imipenem-resistant P. aeruginosa increased significantly in the time period evaluated by the SENTRY Program. MbetaL-producing P aeruginosa was detected in São Paulo (SPM-1) and Brasilia (SPM-1 and IMP-16). Brazil and Caracas, Venezuela (VIM-2); while MbetaL-producing Acinetobacter spp. isolates were detected in São Paulo, Brazil (IMP-1). P. fluorescens isolates producing IMP-1 and VIM-2 were detected in São Paulo, Brazil and Santiago, Chile, respectively. the emergence and dissemination of mobile NXIOLproducing isolates represent an alarming factor for increasing resistance to carbapenems in several medical centres evaluated by the SENTRY Program in Latin America. (C) 2004 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.
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A divulgação de relatórios de sustentabilidade na América Latina: um estudo comparativo
(Departamento de Administração da Faculdade de Economia, Administração e Contabilidade da Universidade de São Paulo, 2013-12-01) Calixto, Laura [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)
This work aims to comparatively analyze the social and environmental information disseminated by Latin American companies in their reports. A content analysis was made of the social and environmental information disclosed by a sample of 226 organizations, in the period from 2004 to 2009, categorized by country, company, industry, and year. Voluntary guidelines by The Global Reporting Initiative were used as a guide to analyze the content of annual reports, sustainability reports and 20F Forms, made available by organizations on their websites or by the stock exchanges on which they negotiate their actions. The results reveled that most trading companies in the region do not provide social and environmental information in their annual reports or specific reports on the subject, however, companies established in Brazil are most emphasis this issue. Regarding the development and dissemination of social-environmental information, it was noted that the annual report has become the main source used for this purpose, followed by the sustainability report, published as part of the annual report or as a specific publication.

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