Publications by authors named "Diana Paez"

More than a billion people live in fragile, conflict-affected, and vulnerable settings requiring humanitarian support, where cancer is a substantial health issue. Despite its substantial effect on populations, cancer care remains underprioritised in emergency preparedness and response frameworks and humanitarian operational planning. This Policy Review summarises the perspectives and actionable recommendations from the First Global High-Level Technical Meeting on Non-communicable Diseases in Humanitarian Settings, with a focus on cancer.

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  • The study evaluates the recovery of cardiac diagnostic procedures in Italy one year after the COVID-19 outbreak, focusing on procedure volumes, practices, and staff well-being.
  • A global survey revealed a 72% drop in cardiac diagnostic procedures in April 2020 compared to March 2019, with only a slight recovery (3% increase) by April 2021, though some specific tests showed increased volumes.
  • Many healthcare centers adopted measures like physical distancing and COVID-19 screening, but 25% of physicians reported high psychological stress levels, highlighting ongoing challenges within the healthcare system.
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  • - The Lancet Oncology Commission focuses on improving global access to radiotherapy and theranostics, addressing significant disparities between high-income countries and low-income and middle-income countries (LMICs) concerning available treatment resources and trained healthcare professionals.
  • - The implementation of hypofractionation techniques in radiotherapy could increase treatment access for millions of patients with prostate and breast cancer, highlighting the need for new technologies in LMICs with existing resources.
  • - A global survey revealed variability in the use of radiopharmaceutical therapy, with issues related to supply chains and workforce training impacting access; initiatives like the International Atomic Energy Agency's Rays of Hope program and investment from development banks are encouraged to improve the situation.
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  • This study reviews the effectiveness of PET/MRI in diagnosing head and neck squamous cell carcinoma (HNSCC) by analyzing various research findings.
  • A systematic search identified 15 relevant studies with a total of 638 patients, focusing on the diagnostic accuracy of PET/MRI for different types of HNSCC.
  • The analysis showed high sensitivity and specificity for PET/MRI in detecting primary, locoregional, and nodal cancers, suggesting it may be more accurate than other imaging methods, though the difference was not statistically significant.
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Health problems in the Latin American and the Caribbean (LAC) region are highly concentrated on non-communicable diseases, being cardiovascular diseases (CVDs) and cancer the leading causes of death. Different countries of the region are at different stages of development in addressing CVDs and cancer. Opportunities for training and continuing education in cardio-oncology, as well as active cardio-oncology groups, are primarily limited to large academic institutions in major metropolitan areas.

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Theranostics has become a major area of innovation and progress in cancer care over the last decade. In view of the introduction of approved therapeutics in neuroendocrine tumours and prostate cancer in the last 10 years, the ability to provide access to these treatments has emerged as a key factor in ensuring global benefits from this cancer therapy approach. In this Series paper we explore the issues that affect access to and availability of theranostic radiopharmaceuticals, including supply and regulatory issues that might affect the availability of theranostic treatments for patients with cancer.

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  • This paper is the first in a series about theranostics, which is a way to use special medicines to help treat cancer.
  • It talks about new and cool discoveries in making these medicines and using smart technology to improve them.
  • The authors also mention some problems that need to be solved to make these cancer treatments even better in the future.
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Background: In this substudy of the Value of Gated-SPECT MPI for Ischemia- Guided PCI of non-culprit vessels in STEMI Patients with Multi vessel Disease after primary PCI trial after primary PCI we aim to assess if infarct size affects conventional measures of dyssynchrony at rest. Additionally, we explore if there is an independent correlation of stress-inducible ischemia with dyssynchrony at rest.

Methods: The 48 patients with imaging at randomization were analyzed.

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The utilization of chimeric antigen receptor (CAR) T-cell therapy to target cluster of differentiation (CD)19 in cancer immunotherapy has been a recent and significant advancement. Although this approach is highly specific and selective, it is not without complications. Therefore, a systematic review was conducted to assess the current state of positron emission tomography (PET) in evaluating the adverse effects induced by CAR T-cell therapy.

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Spondylodiscitis, characterized by inflammation of the intervertebral disc and adjacent vertebral bodies, presents a diagnostic challenge due to its nonspecific clinical manifestations and variable imaging findings. This review examines the role of PET-CT with FDG, in the evaluation of spondylodiscitis, focusing on its utility in diagnosis, assessment of disease extent, treatment response monitoring, and prognostication. FDG PET-CT, by combining metabolic and anatomical imaging modalities, offers superior sensitivity and specificity compared to conventional imaging techniques in detecting infectious foci, distinguishing between infection and post-treatment changes, and identifying occult sources of infection.

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2-Deoxy-2-[ 18 F]fluoro- d -glucose PET/computed tomography ([ 18 F]FDG PET/CT) has proven to be a sensitive method for the detection and evaluation of hematologic malignancies, especially lymphoma. The increasing incidence and mortality rates of leukemia have raised significant concerns. Through the utilization of whole-body imaging, [ 18 F]FDG PET/CT provides a thorough assessment of the entire bone marrow, complementing the limited insights provided by biopsy samples.

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Medical imaging is both valuable and essential in the care of patients. Much of this imaging depends on ionizing radiation with attendant responsibilities for judicious use when performing an examination. This responsibility applies in settings of both individual as well as multiple (recurrent) imaging with associated repeated radiation exposures.

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  • - The COVID-19 pandemic significantly disrupted cardiovascular testing in Latin America (LATAM), with a study finding a 21% decrease in procedure volumes from pre-pandemic levels in April 2021, contrasting with zero change in the rest of the world.
  • - Central America and Mexico experienced the largest reductions in procedures (47%), while healthcare centers in LATAM reported more staff layoffs and salary cuts than those in other regions.
  • - The study highlighted the lasting effects of the pandemic on cardiovascular care and emphasized the need for mental health support for healthcare workers in LATAM, as nearly 50% reported excessive psychological stress.
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  • The synchronous development of radiotherapy (RT) and theranostics is essential for improving survival and quality of life for cancer patients worldwide.
  • An international collective, organized by the IAEA, analyzed and compared the challenges and advances in RT and theranostics infrastructure in six countries: Belgium, Brazil, Costa Rica, Jordan, Mongolia, and South Africa.
  • Despite progress, significant disparities in the availability of medical professionals persist, and enhancing collaboration, implementing audits, and adopting innovative technologies are key to accelerating advancements in cancer treatment globally.
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Aims: Current machine learning-based (ML) models usually attempt to utilize all available patient data to predict patient outcomes while ignoring the associated cost and time for data acquisition. The purpose of this study is to create a multi-stage machine learning model to predict cardiac resynchronization therapy (CRT) response for heart failure (HF) patients. This model exploits uncertainty quantification to recommend additional collection of single-photon emission computed tomography myocardial perfusion imaging (SPECT MPI) variables if baseline clinical variables and features from electrocardiogram (ECG) are not sufficient.

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  • * A Consultancy Meeting at the IAEA in May 2023 brought together global experts to discuss the creation of a comprehensive training curriculum for theranostics.
  • * A harmonized training program was established to promote safe and high-quality theranostics practices worldwide, ensuring competency among both new and existing specialists.
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The field of nuclear medicine has witnessed significant advancements in recent years, particularly in the area of PET imaging. One such development is the use of Fibroblast Activation Protein Inhibitors (FAPI) as a novel radiotracer. FAPI PET imaging has shown promising results in various malignancies, including sarcomas, which are a diverse group of cancers originating from mesenchymal cells.

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  • The study aimed to evaluate the recovery of cardiac diagnostic procedure volumes in Oceania during the COVID-19 pandemic by comparing data from March 2019, April 2020, and April 2021 across various health facilities.
  • Results showed that 11,902 procedures were performed in April 2021, slightly below pre-pandemic levels, while the rest of the world had similar recovery rates, indicating a small decline in both regions.
  • Although there were no significant differences in overall recovery rates, anatomical coronary testing in Oceania demonstrated poorer recovery compared to the rest of the world, raising concerns about specific diagnostic procedures.
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  • A special tool called the Patient Journey Audit Tool (PJAT) was created to make sure patients in nuclear medicine get the best care possible.
  • The PJAT has 32 questions to check if the department is following health and safety rules, including patient safety and infection control.
  • After auditing 180 patient journeys, the results showed over 85% compliance with health standards, with perfect scores on very important safety checks.
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Background: In the rapidly evolving field of nuclear medicine, the paramount importance of radiation protection, safety, and quality systems cannot be overstated. This document provides a comprehensive analysis of the intricate regulatory frameworks and guidelines, meticulously crafted and updated by national and international regulatory bodies to ensure the utmost safety and efficiency in the practice of nuclear medicine.

Methods: We explore the dynamic nature of these regulations, emphasizing their adaptability in accommodating technological advancements and the integration of nuclear medicine with other medical and scientific disciplines.

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Objective: To evaluate the impact of a curricular intervention to promote health-related fitness (HRF) among medical students in Bogota, Colombia.

Method: The study was conducted between May 2014 and December 2015 as part of the medical physiology course, in which 208 medical students were enrolled.The curricular intervention included two lectures on physical activity (PA) and student-led group presentations on the physiological effects of exercise on human physiology.

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Background: The physical activity (PA) prescription workshop for physicians, through the global health initiative "Exercise is Medicine" (EIM), has trained more than 4000 health care professionals (HCPs) in Latin America. It has shown to be effective in increasing PA prescription knowledge and awareness among HCPs. The purpose of this paper is to evaluate the curricular and pedagogical approach used by EIM Colombia at the PA prescription workshops implemented between 2014 and 2015.

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Quality Management Audits in Nuclear Medicine (QUANUM) is an initiative conceived by the International Atomic Energy Agency to enhance global standards in Nuclear Medicine practices. Acknowledging the intricate regulatory frameworks and the necessity for multidisciplinary collaboration, QUANUM has gained global acceptance, demonstrating widespread implementation and positive impacts on patient care. This manuscript critically evaluates the QUANUM program through the lens of quality improvement (QI), by employing established and validated QI tools.

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