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Risk and impact of stroke across 38 countries and territories of the Americas from 1990 to 2021: a population-based trends analysis from the Global Burden of Disease Study 2021
(Elsevier BV, 2025-03)
Ramón Martinez
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MUÑOZ VENTURELLI, PAULA ANDREA
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Pedro Ordunez
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Felipe Fregni
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Carlos Abanto
3Scopus© Citations 24
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Getting long-term oxygen therapy right
(Elsevier BV, 2025-06)
Masooma Aqeel
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CZISCHKE LJUBETIC, KAREN NICOLE
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Ayham Daher
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Mike Hess
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Chidiamara Maria Njoku
Scopus© Citations 1 2
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Cancer plans should consider local needs
(Elsevier BV, 2025-02)
Bettina Müller
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Raul Murillo
1Scopus© Citations 2
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Unravelling the potential relationship between the climate crisis and the health of migrant children in LAC: perceptions from migrant parents and healthcare professionals in Chile
(BMJ, 2024-12)
CARREÑO CALDERON, ALEJANDRA ANGELICA
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Alice Bluckaz
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CABIESES VALDES, BALTICA BEATRIZ
<jats:sec><jats:title>Introduction</jats:title><jats:p>Latin America and the Caribbean (LAC) is one of the regions most affected by the climate crisis, which is connected to international migration through a complex nexus. During the last years, migratory flows on the continent have increasingly included children and adolescents who are migrating through non-authorised crossing points. The existing literature shows how inequities negatively affect migrant children and the role that healthcare systems can play to mitigate them.</jats:p></jats:sec><jats:sec><jats:title>Objective</jats:title><jats:p>Based on a qualitative study, the paper aims to analyse the role of the climate crisis on the healthcare needs of migrant children from LAC who are currently living in Chile, from the point of view of parents from five main countries of immigration in Chile and healthcare professionals.</jats:p></jats:sec><jats:sec><jats:title>Method</jats:title><jats:p>An exploratory study was conducted in Arica, Antofagasta and Santiago. In-depth interviews with 20 migrant parents and 20 healthcare professionals were carried out. The interviews were transcribed verbatim and a thematic analysis was performed.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Three findings emerged from this study: (1) food insecurity affects LAC migrant children in their country of origin and during their migratory trajectories to Chile, (2) natural disasters and environmental degradation in the countries of origin are not the only drivers of migration for LAC families but also prevent returns, even when they remain undocumented and (3) LAC migrant children are exposed to urban pollution and contaminants in informal settlements due to difficulties in accessing formal housing, among others.</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The climate crisis must be integrated into the study of migrant health in LAC, considering the current context of multiple political, health and economic crises in the region. Healthcare professionals and communities play a central role in creating interventions to build sustainable and resilient universal healthcare systems.</jats:p></jats:sec>
Scopus© Citations 1 1
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Determinants of COVID-19 and non-COVID-19 vaccine confidence in low- and middle-income countries: A systematic review of qualitative evidence and thematic synthesis
(2025)
Alice Blukacz
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OBACH KING, ALEXANDRA ALICE
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Paola Vásquez
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CAMPAÑA, CARLA
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Catalina Huerta
Scopus© Citations 1 2
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The Lancet Oncology Commission: Radiotherapy & Theranostic Services in LMICs: Minding & Mending the Gaps
(2024)
Jaleelat I. Momodu
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Claudia Carvajal
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Daniel A. Pryma
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Hannah Ayettey Anie
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Jeff M. Michalski
1Scopus© Citations 1
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Usability and feasibility of PreventS-MD web app for stroke prevention
(2023)
Valery L Feigin
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Rita Krishnamurthi
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Oleg Medvedev
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Alexander Merkin
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Balakrishnan Nair
<jats:sec><jats:title>Background:</jats:title><jats:p> Most strokes and cardiovascular diseases (CVDs) are potentially preventable if their risk factors are identified and well controlled. Digital platforms, such as the PreventS-MD web app (PreventS-MD) may aid health care professionals (HCPs) in assessing and managing risk factors and promoting lifestyle changes for their patients. </jats:p></jats:sec><jats:sec><jats:title>Methods:</jats:title><jats:p> This is a mixed-methods cross-sectional two-phase survey using a largely positivist (quantitative and qualitative) framework. During Phase 1, a prototype of PreventS-MD was tested internationally by 59 of 69 consenting HCPs of different backgrounds, age, sex, working experience, and specialties using hypothetical data. Collected comments/suggestions from the study HCPs in Phase 1 were reviewed and implemented. In Phase 2, a near-final version of PreventS-MD was developed and tested by 58 of 72 consenting HCPs using both hypothetical and real patient (n = 10) data. Qualitative semi-structured interviews with real patients (n = 10) were conducted, and 1 month adherence to the preventive recommendations was assessed by self-reporting. The four System Usability Scale (SUS) groups of scores (0–50 unacceptable; 51–68 poor; 68–80.3 good; >80.3 excellent) were used to determine usability of PreventS-MD. </jats:p></jats:sec><jats:sec><jats:title>Findings:</jats:title><jats:p> Ninety-nine HCPs from 27 countries (45% from low- to middle-income countries) participated in the study, and out of them, 10 HCPs were involved in the development of PreventS before the study, and therefore were not involved in the survey. Of the remaining 89 HCPs, 69 consented to the first phase of the survey, and 59 of them completed the first phase of the survey (response rate 86%), and 58 completed the second phase of the survey (response rate 84%). The SUS scores supported good usability of the prototype (mean score = 80.2; 95% CI [77.0–84.0]) and excellent usability of the final version of PreventS-MD (mean score = 81.7; 95% CI [79.1–84.3]) in the field. Scores were not affected by the age, sex, working experience, or specialty of the HCPs. One-month follow-up of the patients confirmed the high level of satisfaction/acceptability of PreventS-MD and (100%) adherence to the recommendations. </jats:p></jats:sec><jats:sec><jats:title>Interpretation:</jats:title><jats:p> The PreventS-MD web app has a high level of usability, feasibility, and satisfaction by HCPs and individuals at risk of stroke/CVD. Individuals at risk of stroke/CVD demonstrated a high level of confidence and motivation in following and adhering to preventive recommendations generated by PreventS-MD. </jats:p></jats:sec>
Scopus© Citations 9 2
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High Burden of Intestinal Colonization With Antimicrobial-Resistant Bacteria in Chile: An Antibiotic Resistance in Communities and Hospitals (ARCH) Study
(2023)
ARAOS BRALIC, RAFAEL IGNACIO
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Rachel M Smith
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Ashley Styczynski
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Felipe Sánchez
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Lea Maureira
<jats:title>Abstract</jats:title> <jats:sec> <jats:title>Background</jats:title> <jats:p>Antimicrobial resistance is a global threat, heavily impacting low- and middle-income countries. This study estimated antimicrobial-resistant gram-negative bacteria (GNB) fecal colonization prevalence in hospitalized and community-dwelling adults in Chile before the coronavirus disease 2019 pandemic.</jats:p> </jats:sec> <jats:sec> <jats:title>Methods</jats:title> <jats:p>From December 2018 to May 2019, we enrolled hospitalized adults in 4 public hospitals and community dwellers from central Chile, who provided fecal specimens and epidemiological information. Samples were plated onto MacConkey agar with ciprofloxacin or ceftazidime added. All recovered morphotypes were identified and characterized according to the following phenotypes: fluoroquinolone-resistant (FQR), extended-spectrum cephalosporin-resistant (ESCR), carbapenem-resistant (CR), or multidrug-resistant (MDR; as per Centers for Disease Control and Prevention criteria) GNB. Categories were not mutually exclusive.</jats:p> </jats:sec> <jats:sec> <jats:title>Results</jats:title> <jats:p>A total of 775 hospitalized adults and 357 community dwellers were enrolled. Among hospitalized subjects, the prevalence of colonization with FQR, ESCR, CR, or MDR-GNB was 46.4% (95% confidence interval [CI], 42.9–50.0), 41.2% (95% CI, 37.7–44.6), 14.5% (95% CI, 12.0–16.9), and 26.3% (95% CI, 23.2–29.4). In the community, the prevalence of FQR, ESCR, CR, and MDR-GNB colonization was 39.5% (95% CI, 34.4–44.6), 28.9% (95% CI, 24.2–33.6), 5.6% (95% CI, 3.2–8.0), and 4.8% (95% CI, 2.6–7.0), respectively.</jats:p> </jats:sec> <jats:sec> <jats:title>Conclusions</jats:title> <jats:p>A high burden of antimicrobial-resistant GNB colonization was observed in this sample of hospitalized and community-dwelling adults, suggesting that the community is a relevant source of antibiotic resistance. Efforts are needed to understand the relatedness between resistant strains circulating in the community and hospitals.</jats:p> </jats:sec>
Scopus© Citations 10 2
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Head-to-head comparison of CAMPYAIR aerobic culture medium versus standard microaerophilic culture for Campylobacter isolation from clinical samples
(2023)
Arturo Levican
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Carmen Varela
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Lorena Porte
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WEITZEL, THOMAS
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Isabel Briceño
<jats:p><jats:italic>Campylobacter</jats:italic> spp. are considered the most frequent cause of acute gastroenteritis worldwide. However, outside high-income countries, its burden is poorly understood. Limited published data suggest that <jats:italic>Campylobacter</jats:italic> prevalence in low- and middle-income countries is high, but their reservoirs and age distribution are different. Culturing <jats:italic>Campylobacter</jats:italic> is expensive due to laboratory equipment and supplies needed to grow the bacterium (e.g., selective culture media, microaerophilic atmosphere, and a 42°C incubator). These requirements limit the diagnostic capacity of clinical laboratories in many resource-poor regions, leading to significant underdiagnosis and underreporting of isolation of the pathogen. CAMPYAIR, a newly developed selective differential medium, permits <jats:italic>Campylobacter</jats:italic> isolation without the need for microaerophilic incubation. The medium is supplemented with antibiotics to allow <jats:italic>Campylobacter</jats:italic> isolation in complex matrices such as human feces. The present study aims to evaluate the ability of the medium to recover <jats:italic>Campylobacter</jats:italic> from routine clinical samples. A total of 191 human stool samples were used to compare the ability of CAMPYAIR (aerobic incubation) and a commercial <jats:italic>Campylobacter</jats:italic> medium (CASA, microaerophilic incubation) to recover <jats:italic>Campylobacter</jats:italic>. All <jats:italic>Campylobacter</jats:italic> isolates were then identified by MALDI-TOF MS. CAMPYAIR showed sensitivity and specificity values of 87.5% (95% CI 47.4%–99.7%) and 100% (95% CI 98%–100%), respectively. The positive predictive value of CAMPYAIR was 100% and its negative predictive value was 99.5% (95% CI 96.7%–99.9%); Kappa Cohen coefficient was 0.93 (95% CI 0.79–1.0). The high diagnostic performance and low technical requirements of the CAMPYAIR medium could permit <jats:italic>Campylobacter</jats:italic> culture in countries with limited resources.</jats:p>
Scopus© Citations 3 1
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Structural brain abnormalities in schizophrenia in adverse environments: examining the effect of poverty and violence in six Latin American cities
(2020)
Nicolas A. Crossley
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Andre Zugman
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Francisco Reyes-Madrigal
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Leticia S. Czepielewski
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Mariana N. Castro
<jats:title>Summary</jats:title><jats:sec id="S0007125020001439_sec_a1"><jats:title>Background</jats:title><jats:p>Social and environmental factors such as poverty or violence modulate the risk and course of schizophrenia. However, how they affect the brain in patients with psychosis remains unclear.</jats:p></jats:sec><jats:sec id="S0007125020001439_sec_a2"><jats:title>Aims</jats:title><jats:p>We studied how environmental factors are related to brain structure in patients with schizophrenia and controls in Latin America, where these factors are large and unequally distributed.</jats:p></jats:sec><jats:sec id="S0007125020001439_sec_a3" sec-type="methods"><jats:title>Method</jats:title><jats:p>This is a multicentre study of magnetic resonance imaging in patients with schizophrenia and controls from six Latin American cities. Total and voxel-level grey matter volumes, and their relationship with neighbourhood characteristics such as average income and homicide rates, were analysed with a general linear model.</jats:p></jats:sec><jats:sec id="S0007125020001439_sec_a4" sec-type="results"><jats:title>Results</jats:title><jats:p>A total of 334 patients with schizophrenia and 262 controls were included. Income was differentially related to total grey matter volume in both groups (<jats:italic>P</jats:italic> = 0.006). Controls showed a positive correlation between total grey matter volume and income (<jats:italic>R</jats:italic> = 0.14, <jats:italic>P</jats:italic> = 0.02). Surprisingly, this relationship was not present in patients with schizophrenia (<jats:italic>R</jats:italic> = −0.076, <jats:italic>P</jats:italic> = 0.17). Voxel-level analysis confirmed that this interaction was widespread across the cortex. After adjusting for global brain changes, income was positively related to prefrontal cortex volumes only in controls. Conversely, the hippocampus in patients with schizophrenia, but not in controls, was relatively larger in affluent environments. There was no significant correlation between environmental violence and brain structure.</jats:p></jats:sec><jats:sec id="S0007125020001439_sec_a5" sec-type="conclusions"><jats:title>Conclusions</jats:title><jats:p>Our results highlight the interplay between environment, particularly poverty, and individual characteristics in psychosis. This is particularly important for harsh environments such as low- and middle-income countries, where potentially less brain vulnerability (less grey matter loss) is sufficient to become unwell in adverse (poor) environments.</jats:p></jats:sec>
Scopus© Citations 10 1

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