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PubMed1996

Systemic lupus erythematosus in males. A study of 107 Latin American patients.

Clinical and laboratory features were analyzed in 107 Latin American male patients with systemic lupus erythematosus (SLE) who were compared with a group of 1,209 Latin American female patients with SLE to determine the presence of gender-associated differences. Males had an increased prevalence of renal disease, vascular thrombosis, and the presence of anti-dsDNA antibodies, as well as the use of moderate to high doses of corticosteroids, compared with female SLE patients. Although there was no difference in mortality from all causes, SLE-related mortality was higher in the male group. All these findings are consistent with a more severe disease in Latin American males than in female patients from the same region.

Adolescent↗

PubMed2005

Study of the integrated cognitive model of depression among Latin-Americans.

OBJECTIVE: The objective of the present study is to test the validity of the integrated cognitive model (ICM) of depression proposed by Kwon and Oei with a Latin-American sample. The ICM of depression postulates that the interaction between negative life events with dysfunctional attitudes increases the frequency of negative automatic thoughts, which in turns affects the depressive symptomatology of a person. This model was developed for Western Europeans such as Americans and Australians and the validity of this model has not been tested on Latin-Americans. METHOD: Participants were 101 Latin-American migrants living permanently in Brisbane, including people from Chile, El Salvador, Nicaragua, Argentina and Guatemala. Participants completed the Beck Depression Inventory, the Dysfunctional Attitudes Scale, the Automatic Thoughts Questionnaire and the Life Events Inventory. Alternative or competing models of depression were examined, including the alternative aetiologies model, the linear mediational model and the symptom model. RESULTS: Six models were tested and the results of the structural equation modelling analysis indicated that the symptom model only fits the Latin-American data. CONCLUSIONS: Results show that in the Latin-American sample depression symptoms can have an impact on negative cognitions. This finding adds to growing evidence in the literature that the relationship between cognitions and depression is bidirectional, rather than unidirectional from cognitions to symptoms.

Adaptation, Psychological↗

PubMedDate not supplied

[International cooperation for research in public health: the case of the Latin American Network of Perinatal Investigation].

Health research in Latin America faces serious shortcomings, especially considering the region's dire needs. Multicenter collaboration can be a valuable tool to promote scientific development. In 1985, investigators of four Latin American epidemiologic research centers created the Latin American Network for Perinatal Research. The analysis of the difficulties we had to face in order to implement the first joint study illustrates the obstacles people involved in multicenter projects have to overcome. The conclusion is that in spite of the difficulties, multicenter work is feasible and to be recommended. Results of this kind of studies reach a great external validity and are applicable to broad population sectors.

Argentina↗

PubMedDate not supplied

Social security reform in Central and Eastern Europe: variations on a Latin American theme.

After Chile reformed its social security system in 1981, several other Latin American countries and certain Central and Eastern European (CEE) countries implemented the Chilean model, with some variations: either a single- or multitier system, or with a period of transition to take care of those in the labor force at the time of the change. The single-tier version consists of individual accounts in pension fund management companies. Multi-tier systems retain some form of public program and add mandatory individual accounts. Most of the CEE countries did not want to incur the high transition costs associated with the Chilean model. The switch to a market economy had already strained their economies. Also, the countries' desire to adopt the European Union's Euro as their currency--a move that required a specific debt ceiling--limited the amount of additional debt they could incur. This article describes the CEE reforms and makes some comparisons with the Latin American experience. Most of the CEE countries have chosen a mixed system and have restructured the pay-as-you-go (PAYGO) tier, while the Latin American countries have both single- and multi-tier systems. Some CEE countries have set up notional defined contribution (NDC) schemes for the PAYGO tier in which each insured person has a hypothetical account made up of all contributions during his or her working life. Survivors and disability programs in CEE have remained in the public tier, but in most of the Latin American programs the insured must purchase a separate insurance policy. Issues common to both regions include: Administrative costs are high and competition is keen, which has led to consolidation and mergers among the companies and a large market share controlled by a few companies. Benefits are proportionately lower for women than for men. A large, informal sector is not covered by social security. This sector is apparently much larger in Latin America than in the CEE countries. Issues that are unique to some of the CEE countries include: Individual accounts in Hungary and Poland have proved more attractive than originally anticipated. As a result, contributions to the public PAYGO system in Hungary and Poland fell short of expectations. In several countries, laws setting up the programs were enacted without all the details of providing benefits. For example, in some countries laws must now be drawn up for establishment of annuities because they do not yet exist. Setting up a coherent pension policy has been difficult in some countries because of frequent and significant changes in government. This situation has affected the progress of reform in various stages of development. In general, a definitive assessment of individual accounts in these countries will not be possible until a cohort of retirees has spent most of its career under the new system.

Aged↗

PubMed1999

[The history of genetics in Latin American countries during the twentieth century].

The aim of this historical review is to evaluate the evolution of genetics in the context of Latin American scientific culture, to value foreign influences and to highlight the discoveries and contributions of Latin American geneticists. During the first third of the twentieth century, local naturalists, botanists and physicians understood the chromosomal theory of heredity and Mendelian theory of evolution and begun research and teaching on these new theories and technologies. During the thirties and forties, North American geneticists visited South America and formed development poles on cytogenetics and population genetics in Brazil and Argentina. During the fifties and sixties, human genetics was formally established in Brazil, Argentina and Chile. Genetics teaching became generalized in universities and national Genetics Societies were formed. In 1969, the Latin American Genetics Society was created, unifying the efforts of zoologists, botanists, physicians and anthropologists in an unique Latin American cultural space, organizing 11 meetings between 1972 and 1994. Latin Americans have made a great contribution in genome discovery of animal, vegetable and human species in their territory. They explored the great genetic diversity of the continent, discovering new genes and diseases. The biomedical area had the greatest development. In 1997, there were 130 medical genetics centers, 120 hospitals specialized in congenital malformations, 56 molecular biology centers and 26 molecular genetics centers. At the end of the twentieth century, human genetics is completely integrated to medical sciences in Latin America.

Animals↗

PubMed2002

Four-year evaluation of frequency of occurrence and antimicrobial susceptibility patterns of bacteria from bloodstream infections in Latin American medical centers.

As part of the Latin American arm of the SENTRY Antimicrobial Surveillance Program, 7,207 bacterial isolates collected consecutively from bloodstream infections (BSI) during the period of January 1997 through December 2000 were analyzed. Ten Latin American laboratories located in six countries participated in the study during each year. Antimicrobial susceptibility testing was performed using the reference NCCLS broth microdilution method. The most frequently isolated species were (n/%): Staphylococcus aureus (1,532/21.3%), Escherichia coli (1,239/17.2%), coagulase-negative Staphylococcus (1,002/13.9%), Klebsiella pneumoniae (664/9.2%), and Pseudomonas aeruginosa (470/6.5%). The prevalence of S. aureus as a cause of BSI increased from 20.5% in 1997 to 23.3% in 2000 (p = 0.011), but oxacillin-resistance rates remained relatively stable during this period (around 30%). Enterococci (216 isolates) showed low rates of resistance to both vancomycin (2.4%) and ampicillin (7.9%) and 72.7% of 289 Streptococcus pneumoniae isolates evaluated were susceptible to penicillin (MIC </=0.06 microg/mL). Resistance rates among Gram-negative bacilli were much higher than those reported in other regions evaluated in the SENTRY Program. The main antimicrobial resistance problems among these pathogens were the high prevalences of ESBL-producing E. coli (6.7%) and K. pneumoniae (47.3%), and carbapenem-resistance among P. aeruginosa (around 12%) and Acinetobacter spp. (around 10%). P. aeruginosa resistance rates to meropenem, piperacillin/tazobactam, amikacin, and ciprofloxacin showed a significant increase during the 4-year period evaluated. Resistance rates varied according to the country for several pathogen-antimicrobial combinations. In summary, resistance to most antimicrobial agents for a number of species implicated in bacteremia, especially among Gram-negative rods, has reached worrisome levels and continues to increase.

Anti-Bacterial Agents↗

PubMed1998

[Original contributions of Latin Americans to anesthesiology].

The original contributions of Latin American physicians to the science of anesthesiology are described. Many contributions have been unfairly ignored mainly because they were never published in English, but others have likewise been passed over even when published in the most prestigious journals in the field. Although many discoveries by Latin Americans have been made in the area of regional anesthesia, a considerable number of contributions have involved other aspects of anesthesia as well.

Anesthesiology↗

PubMed1998

Adaptation to pregnancy in three different ethnic groups: Latin-American, African-American, and Anglo-American.

Interview assessments on adaptation to pregnancy were made of Latin-American (N = 30), African-American (N = 34), and Anglo-American (N = 30) women in the latter half of their pregnancy. Most subjects were 18-27 years old, single, had 12 years or less education, and had a parity of 0 or 1. Psychosocial measures of adaptation to pregnancy included Acceptance of Pregnancy, Identification with Motherhood Role, Relationship with Mother and with Husband/Partner, and Preparation for Labour. Data were analyzed using chi-square for group differences. The results indicate that in all 3 groups pregnancy was unplanned but wanted. African Americans least often anticipated life changes as a result of pregnancy, cited fewest aspects of pregnancy that were gratifying to them, and least often chose to stay home with their infant. Most women in all ethnic groups reflected on their role as mother, but Latin Americans most often indicated that they wanted to be like their own mother and that they consulted with their mother about pregnancy and parenting. African Americans least often anticipated domestic help from their partner and most often expected help from other family members. Regarding intimate relationships with husband/partner, for all groups sexual intercourse decreased during pregnancy. Anglo-Americans reported the least number of problems/discomforts with intercourse, Latin Americans the most. Anglo-Americans most often found alternative methods of sexually satisfying their partner, African Americans least often. The results of this exploratory study have significance for differences in the delivery of health care to the 3 ethnic groups and warrant further research.

Adaptation, Psychological↗

PubMed2003

Latin American social medicine: roots, development during the 1990s, and current challenges.

Latin American social medicine arose during the 1950s and 1960s, drawing its inspiration from the social movements that emerged in France, Germany, and England in the mid-19th century. The Latin American movement of social medicine has clear ideological goals. It is organized around the Latin American Association of Social Medicine, which was founded in 1984 and is regarded as a social, political, and academic movement. This article takes a historical perspective and presents the reasons for the emergence and identity of the association, focusing on the main developments and contributions of this movement from the 1990s until the present time.

Consumer Advocacy↗

PubMed2006

Latin American position on the current status of hormone therapy during the menopausal transition and thereafter.

OBJECTIVE: Data from placebo-controlled, randomized clinical trials conducted during the past few years resulted in critical re-evaluation of the overall health benefits of hormone therapy (HT) in women during the menopausal transition and thereafter. These data stimulated vigorous debate among experts and produced several position papers by North American and European authorities providing guidance on the use of HT. It is well known that cultural, geographic and ethnic differences influence the acceptance and risk perception of HT. Therefore, it was considered essential to present a position specifically relevant to Latin American countries. METHODS: A Latin American Expert Panel, convening in Salvador, Bahia, Brazil, obtained consensus on recommendations for HT that incorporated the findings of the most recently published reports. The panelists' opinions were surveyed by means of the Likert scale along five categories ranging from complete agreement to complete disagreement. RESULTS: The Panel presented 13 recommendations and considered three additional issues relevant to HT use. There was consensus that HT during the perimenopause and thereafter is warranted in Latin American women in particular for the management of vasomotor symptoms. HT may also be an option for osteoporosis prevention in women at significant risk, after evaluation of risks/benefits and after consideration of alternative therapies. HT should be individualized and prescribed at the lowest effective dose. CONCLUSIONS: The Panel concluded that HT remains a safe and effective treatment option for peri- and postmenopausal Latin American women.

Estrogen Replacement Therapy↗

PubMed2005

The avoidable health effects of air pollution in three Latin American cities: Santiago, São Paulo, and Mexico City.

Urban centers in Latin American often face high levels of air pollution as a result of economic and industrial growth. Decisions with regard to industry, transportation, and development will affect air pollution and health both in the short term and in the far future through climate change. We investigated the pollution health consequences of modest changes in fossil fuel use for three case study cities in Latin American: Mexico City, Mexico; Santiago, Chile; and São Paulo, Brazil. Annual levels of ozone and particulate matter were estimated from 2000 to 2020 for two emissions scenarios: (1) business-as-usual based on current emissions patterns and regulatory trends and (2) a control policy aimed at lowering air pollution emissions. The resulting air pollution levels were linked to health endpoints through concentration-response functions derived from epidemiological studies, using local studies where available. Results indicate that the air pollution control policy would have vast health benefits for each of the three cities, averting numerous adverse health outcomes including over 156,000 deaths, 4 million asthma attacks, 300,000 children's medical visits, and almost 48,000 cases of chronic bronchitis in the three cities over the 20-year period. The economic value of the avoided health impacts is roughly 21 to 165 billion Dollars (US). Sensitivity analysis shows that the control policy yields significant health and economic benefits even with relaxed assumptions with regard to population growth, pollutant concentrations for the control policy, concentration-response functions, and economic value of health outcomes. This research demonstrates the health and economic burden from air pollution in Latin American urban centers and the magnitude of health benefits from control policies.

Adolescent↗

PubMed2005

The Latin American Dialysis and Renal Transplantation Registry Annual Report 2002.

Latin America is a conglomerate of adjacent countries having in common a Latin extraction and language (Spanish or Portuguese) and exhibiting extreme variations in socioeconomic status. The Latin American Society of Nephrology and Hypertension Dialysis and Renal Transplantation Registry was created in 1991. Annual data are sent by local societies in 3 forms: patient, center, and country. The prevalence of renal replacement therapy (RRT) (all modalities) increased from 119 patients per million population (pmp) in 1991 to 349 pmp in 2001; the acceptance rate was 91.7 pmp in 2001. Dialysis prevalence was 277 pmp; hemodialysis was the predominant modality, except in Mexico (86% on peritoneal dialysis). The highest dialysis prevalence and acceptance rates were reported by Puerto Rico, Uruguay, and Chile. Among incident patients, diabetic nephropathy (33%) and nephroangioesclerosis (32%) were the primary causes; 38% were older than 65 years old. Renal transplants increased from 3.7 pmp in 1987 to 13.7 pmp in 2001. In 2003, 6357 transplants were performed (55% living donor); the cumulative number performed since 1987 reached 55,947. Prevalence and incidence are low because not all patients with end-stage renal disease have access to RRT because of restricted availability, difficulties in referral, and inequities in coverage. The annual increase in the number of patients on RRT (8%-10%) is higher, proportionally, than the annual growth of the Latin American population in general (1.5%). Efforts must be focused on prevention and treatment of chronic kidney disease, especially in diabetic and older patients, and in implementing better organ donation programs to improve the pool of cadaveric donors.

Adult↗

PubMed2005

[Latin American science museums and equity].

Latin America and the Caribbean form a region of great variations yet marked by cultural resemblances. The origins of the region's countries, of their wealth, and also of their problems are quite similar. Indeed, there are clear points of contact in the most basic aspects, such as each society's worldview. Throughout the region there is a very strong democratizing trend that seeks more just and more educated societies. Science plays a key role in the development as a powerful weapon for tolerance and equity and therefore should be disseminated among the greatest possible number of Latin Americans. Red POP the network for the Popularization of Science and Technology in Latin America and the Caribbean - was created to help reach this goal. Under the auspices of ORCYT-UNESCO, Red POP is an interactive network of centers and programs that work to bring science and technology to the public at large. It fosters exchange, skill-acquisition, and resource use among its members. Based on the network's experience, we explore to what extent science museums favor equity in their home societies.

Education↗

PubMed2001

The Latin American guide for psychiatric diagnosis. A cultural overview.

The ICD-10 Classification of Mental and Behavioral Disorders is being accepted by most countries and by the World Psychiatric Association as the international standard in the field for statistical reporting and for clinical care and research. Emerging now, however, is the need to harmonize international communication with recognition of cultural diversity and specific local requirements. Latin American psychiatrists hold a long-standing commitment to the formulation of a reliable and valid diagnostic system in international psychiatry. Examples of important Latin American contributions include the pioneering use of explicit operational criteria in diagnostic methodology by Horwitz and Marconi in Chile, and the proposal of a multiaxial diagnostic formulation by Leme-Lopes in Brazil. In recent times, two main Latin American efforts at developing diagnostic adaptations to the international classification in psychiatry have emerged. One is the Cuban Glossary of Psychiatry, already in its third edition, and the second is a more ambitious project to develop the Latin American Guide for Psychiatric Diagnosis (GLADP). Departing from the experience gained by the Cuban psychiatry and keeping ICD-10 as the basis for nosological organization of mental disorders, the GLADP is being developed with the contributions of psychiatrists and other mental health professionals from most countries in Latin America. The GLADP comprises 4 parts: (I) historical and cultural framework of Latin American psychiatry; (II) a comprehensive diagnostic process and formulation, (III) psychiatric nosology (including ICD-10 major classes of disorders and Latin American cultural syndromes); and (IV) appendixes (including, a lexicologic glossary, concepts and proposals for future study, and bibliography). This is an overview of the basic principles and dimensions for psychiatric diagnosis in Latin America, with an emphasis on its cultural framework.

Adult↗

PubMed2003

Evaluation of the effects of nateglinide on postprandial glycemia in patients with type 2 diabetes mellitus: a multicenter, multinational, non-randomized, non-controlled Latin American study.

One hundred and sixteen Latin American type 2 diabetic patients previously only on a diet were enrolled in this multicenter, multinational, nonrandomized, noncontrolled study. Only 109 completed the study. After 8 weeks of treatment with 120 mg of nateglinide, administered prior to each meal, the postprandial (2 h) glucose concentration decreased to 85.11 +/- 5.65 mg/dl (p < 0.0001), and HbA(1c) values decreased to 1.06 +/- 0.10% (p < 0.0001). No response differences were detected in relation to age, gender, or ethnicity, but we did encounter a better response in recently diagnosed patients (<or=1 year). No serious adverse events were observed. We can, therefore, conclude that nateglinide is a well-tolerated, safe, and effective insulinotropic agent.

Blood Glucose↗

PubMed1995

Migration and health. A study of Latin American refugees, their exile in Sweden and repatriation.

OBJECTIVE: To analyse and elucidate the migration process in order to identify psycho-social themes which might act as stressors with influence on health. DESIGN: Qualitative in-depth interviews with eleven strategically selected Latin American refugees. SETTING: Latin American refugees living in Lund, a university town, and those who were repatriated to Santiago, Chile. PARTICIPANTS: 11 Latin Americans of whom 4 were repatriated to Chile. RESULTS: The migration process was divided into four courses of events: cultural background and everyday life; organized violence; the exile; the repatriation. "Themes" such as cultural and working identity and high control were extracted from the dialogues as central buffering factors against microbiological or physicochemical disease agents harboured by the individual. CONCLUSIONS: During the exile the cultural barrier, social degradation, guilt, social passivity, and ideological alienation cause a changed identity and low control which increase the vulnerability to psychological distress and physical disease.

Adaptation, Psychological↗

PubMed1998

Obesity in Latin American women and children.

National surveys conducted since 1982 were used to assess maternal and child obesity in Latin American and Caribbean countries and in U. S. residents of Mexican descent. Obesity in women, a body mass index (BMI) >/=30 kg/m2, was 3% in Haiti, 8-10% in eight Latin American countries and 29% in Mexican Americans. Median BMI for Latin American women were near or above the 50th percentile of the general U.S. population; values exceeded the 75th percentile in the case of Mexican Americans. The prevalence of overweight (>1 SD above mean weight-for-height) in children 1-5 y of age ranged from 6% in Haiti to 24% in Peru among 13 countries. Overweight occurred in 24% of Mexican-American children. Prevalences of overweight in children and of obesity in women were greater in urban areas and in households of higher socioeconomic status. Overweight in children increased with higher maternal education; however, in some countries, obesity in women decreased with higher education. No general pattern of change over time was observed in eight countries in overweight in children. Obesity in women increased in the three countries with such data and in Mexican-American women and children. There was a tendency for greater national incomes to be associated with greater obesity levels in women and with lower levels of stunting in children. Levels of obesity in the region indicate a public health concern, particularly among women, considering that studies have identified mortality and morbidity risks associated with obesity in adults.

Adult↗

PubMedDate not supplied

Latin American Guide for Psychiatric Diagnosis (GLDP).

Culturally competent diagnostic systems are necessary for an effective and ethical clinical practice, as cultural diversity of patients increase around the world. Latin American psychiatrists hold a long-standing commitment to this enterprise. Recently, two main Latin American adaptations to the international psychiatric classification have emerged: the Cuban Glossary of Psychiatry, and the project of the Latin American Guide for Psychiatric Diagnosis (GLADP). Keeping ICD-10 as the basis for nosological organization, GLADP is being developed with contributions by mental health professionals from Latin American countries. GLADP comprises 4 parts: (1) historical and cultural framework, (2) comprehensive diagnosis and formulation, (3) psychiatric nosology and (4) appendixes.

Cross-Cultural Comparison↗