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PubMedDate not supplied

[The Free Trade Area of the Americas (FTAA) and the health sector in Latin America].

The Free Trade Area of the Americas-FTAA, which will be implemented in 2005, is the closest expression of economic globalization we will have. In this paper the debate about the neo liberal tendency of globalization is considered: on one side are the defendants of trade, competition and market liberalization; on the other side, those who claim for global social justice, for an alternative globalization, for reaching the ideal of justice in the planet, seriously affected by the free trade agreements, in the absence of a global political power capable of distributing richness. The debate permanently animates this essay on the FTAA which starts with the government proposals and the scope that the interventions of the U.S.A. and the trans-nationals have on the decisions of our countries, besides pointing out to the negative effects that the North American Free Trade Agreement-NAFTA has had on health. Most of the affirmations on the FTAA and its impact on health are derived from its analysis and the new relationships imposed on world trade through organisms as the World Trade Organization-WTO.

Americas↗
PubMed1997

The emerging infections network: a new venture for the Infectious Diseases Society of America. Executive Committee of the Infectious Diseases Society of America Emerging Infections Network.

The Infectious Diseases Society of America (IDSA), in cooperation with the Centers for Disease Control and Prevention, has launched an Emerging Infections Network (EIN). This network of infectious diseases consultants was conceived as a sentinel system to monitor new or resurgent infectious diseases in a way that would complement other public health surveillance efforts. A pilot study with 169 participants recruited from 32 of the IDSA's state and regional societies confirmed the feasibility and potential value of this network. More than 300 infectious diseases consultants are currently participating in the IDSA EIN. Future plans include aggressive probing for clinical experiences that indicate or suggest the presence of emerging infections, initiation of prospective studies for selected infectious diseases, and other activities designed both to benefit consultants in infectious diseases and to make use of their services.

Communicable Disease Control↗
PubMed2000

Update on ISI survey: Europe, North America and South America.

It is well known that the diagnostic process in amyotrophic lateral sclerosis (ALS) may be excessively prolonged, with negative consequences for the patients and their families. The ISIS study assessed the diagnostic process in 201 patients affected by ALS from 6 different countries (Argentina, Brazil, Germany, Italy, Spain and USA). The median time from onset to diagnosis ranged from 12 months in Spain to 17 months in Italy. The median time for patients to have a first consultation with a physician was 2 months (range: 1-1.5 months) and with a neurologist was 6-9 months. The median time needed for the neurologist to confirm the diagnosis was 3-6 months. Electromyography was performed on more than 90% of patients in all countries, and was requested in most cases by the neurologist. False-negative diagnoses were quite frequent (45% of cases with at least one other diagnosis evoked at any time before the ALS diagnosis) and were made by neurologists in 28% of cases, by general practitioners in 29% of cases, by orthopaedic surgeons in 26% of cases and by other specialists in 18% of cases. The reasons for misdiagnoses were: presence of other diseases to which the symptomatology was attributed, misinterpretation of examinations, and lack of familiarity with ALS.

Cross-Cultural Comparison↗
PubMed1999

In vitro activities of BMS-207147 against over 600 contemporary clinical bloodstream isolates of Candida species from the SENTRY Antimicrobial Surveillance Program in North America and Latin America.

We compared the in vitro activity of BMS-207147, an investigational triazole, with those of itraconazole and fluconazole against 613 clinical bloodstream isolates of Candida spp. collected from SENTRY participating hospitals during 1997 and 1998. Overall, BMS-207147 was the most active azole against all Candida spp. While both BMS-207147 and itraconazole displayed a stepwise decrease in activity against isolates for which the fluconazole MICs were elevated, BMS-207147 had two- to fourfold greater activity than itraconazole both against Candida spp. that were dose-dependently fluconazole susceptible and against those that were fluconazole resistant.

Antifungal Agents↗
PubMed2000

A comparative In vitro surveillance study of gemifloxacin activities against 2,632 recent Streptococcus pneumoniae isolates from across Europe, North America, and South America. The Gemifloxacin Surveillance Study Research Group.

From 1997 to 1999, 94 study centers in 15 European, 3 North American, and 2 South American countries contributed 2,632 isolates of Streptococcus pneumoniae to an international antimicrobial susceptibility testing study. Only 62.0% of isolates were susceptible to penicillin, while 22.3% were penicillin intermediate and 15.6% were penicillin resistant. Resistance to trimethoprim-sulfamethoxazole (24.4%), azithromycin (26.0%), and clarithromycin (27.1%) was also highly prevalent. For the penicillin-resistant isolates (n = 411), the MICs at which 90% of isolates are inhibited (MIC(90)s) for gemifloxacin, levofloxacin, ofloxacin, clarithromycin, and azithromycin were 0.03, 1, 2, >16, and >64 microgram/ml, respectively. Similarly, for isolates resistant to both azithromycin and clarithromycin (n = 649), gemifloxacin, levofloxacin, ofloxacin, and penicillin MIC(90)s were 0.03, 1, 2, and 4 microgram/ml, respectively. Overall rates of resistance to trovafloxacin (0.3%), levofloxacin (0.3%), grepafloxacin (0.6%), and ofloxacin (0.7%) were low. For ofloxacin-intermediate and -resistant isolates (n = 142), gemifloxacin had the lowest MIC(90) (0.12 microgram/ml) compared to the MIC(90)s of trovafloxacin (0.5 microgram/ml), grepafloxacin (1 microgram/ml), and levofloxacin (2 microgram/ml). For all S. pneumoniae isolates tested, gemifloxacin MICs were </=0.5 microgram/ml, suggesting that gemifloxacin has the potential to be used as a treatment for pneumococcal infections, including those arising from isolates resistant to beta-lactams and macrolides.

Adolescent↗
PubMed2004

Management of the nontoxic multinodular goiter in Latin America: comparison with North America and Europe, an electronic survey.

To assess diagnostic and therapeutic approaches to nontoxic multinodular goiter and to compare them with previously reported American Thyroid Association (ATA) and European Thyroid Association (ETA) surveys, an online questionnaire was distributed to Latin American Thyroid Society (LATS) members. An index case was presented (42-yr-old woman with an enlarged, irregular, nontender, 50- to 80-g thyroid and no clinical suspicion of malignancy or dysfunction), and 11 variations were proposed to evaluate how each alteration would affect management. We obtained 148 responses (response rate, 50%). In the index case, the most used blood tests were TSH (96%), antithyroid peroxidase antibodies (76%), and free T(4) (64%); 5% included a calcitonin assay. Nearly 90% would perform ultrasound, and only 16% used scintigraphy. Fine needle biopsy was indicated by 88%, with ultrasound guidance in 75% of times. For treatment, observation was preferred by 39%, surgery by 28%, levothyroxine by 21%, and radioiodine by 7% (60% with recombinant TSH prestimulation). A suppressed TSH level prompted 45% of the respondents to recommend radioiodine, whereas 70-78% indicated surgery in the presence of a large goiter or suspicion of malignancy. In conclusion, no consensus exists concerning the ideal management of nontoxic goiter among LATS members, in agreement with previous ATA and ETA surveys. Levothyroxine therapy is less used by LATS than by ATA or ETA members, and a more aggressive therapeutic strategy is generally preferred by members of LATS and ETA compared with ATA.

Adult↗