[More Doctors recruitment program: a new approach to overcome inequalities in human resourcesPrograma Más Médicos: cómo evaluar el impacto de un enfoque innovador para superar las inequidades en recursos humanos].

Despite the 40 years elapsed since the Alma-Ata principles were first launched, a series of challenges still persists for the consolidation of primary health care (PHC) as the backbone of health care systems around the world. Among these challenges, especially noteworthy are the issues associated with the inequality in the allocation of human resources. The experience of the More Doctors Program (, PMM) in Brazil is an example of initiatives that tackle this inconclusive Alma-Ata agenda.

Monitoring and evaluation of the PAHO/WHO cooperation project, the Mais Médicos (More Doctors) Program: a mid-term assessment.

Working relations between the Pan- American Health Organization/World Health Organization (PAHO/WHO) and Brazilian health institutions accumulated a long history of cooperation with mutual benefits, which in many cases were shared with other nations under various cooperation frameworks among countries for health development. A milestone in this relationship is the technical cooperation provided by PAHO/WHO to the More Doctors Program (Programa Mais Médicos - PMM). This cooperation has added both strategic value in reducing gaps in health equality and has capitalized on the unique nature of the Cuba-Brazil South-South cooperation experience, triangulated through PAHO/WHO.

Socioeconomic inequalities and mortality trends in BRICS, 1990-2010.

Objective: To explore the presence and magnitude of--and change in--socioeconomic and health inequalities between and within Brazil, the Russian Federation, India, China and South Africa--the countries known as BRICS--between 1990 and 2010.

Methods: Comparable data on socioeconomic and health indicators, at both country and primary subnational levels, were obtained from publicly available sources. Health inequalities between and within countries were identified and summarized by using standard gap and gradient metrics.

Predictive value of MicroRNAs in the progression of barrett esophagus to adenocarcinoma in a long-term follow-up study.

Objective: The aim of this study is to identify a set of microRNAs (miRNAs) as prognostic molecular biomarkers for the progression of Barrett esophagus (BE) to esophageal adenocarcinoma (EAC) to rationalize the surveillance programs in patients with BE.

Background: Histological dysplasia is currently used as the main biomarker to identify the BE patients at high risk for developing EAC. Although miRNA expression profiles in BE and EAC have been reported, it has not been established which set of miRNAs could constitute a robust diagnostic test to predict the progression of BE to EAC.

Long-term follow-up of malignancy biomarkers in patients with Barrett's esophagus undergoing medical or surgical treatment.

Objective: This study aims to compare some validated biomarkers of malignancy (Ki-67, p53, and apoptosis) between 2 groups of patients with Barrett's esophagus (BE) undergoing randomly medical or surgical treatment.

Background: The treatment of choice to prevent the malignant progression of BE remains controversial. Translational studies using biomarkers associated with the metaplasia-tumor pathway could be useful to provide some information in this regard.

Advocacy and resource mobilization for rubella elimination in Guatemala.

This review describes the advocacy efforts to mobilize resources for the campaign to vaccinate men and women aged 9-39 years, with a goal of eliminating rubella and congenital rubella syndrome in Guatemala. The country's investment in health has been historically low (0.9% of gross domestic product), and there has been a wide gap between the availability of economic resources and the need for economic resources for the immunization campaign.

[Severe lower gastrointestinal tract bleeding due to diverticulosis].

Introduction: Diverticulosis is the most frequent cause of lower gastrointestinal (GI) bleeding in adults in western countries. The aims of the present study were to analyze: 1) the diagnostic and therapeutic management of patients with severe lower GI bleeding due to diverticulosis; 2) associated morbidity and mortality; 3) the need for surgery, and 4) bleeding recurrence rates after hospital discharge.

Material And Methods: Were retrospectively reviewed 42 patients with severe lower GI bleeding due to diverticulosis.

High risk of malignancy in familial Barrett's esophagus: presentation of one family.

Barrett's esophagus is an acquired condition fundamentally related to the presence of severe and prolonged pathologic acid and biliary gastro-esophageal reflux. However, genetic factors may also play a role in some cases. The aim of this study is to present 3 generations of a Spanish family with the largest number of members so far reported with Barrett's esophagus or esophageal adenocarcinoma.

Very long-term objective evaluation of heller myotomy plus posterior partial fundoplication in patients with achalasia of the cardia.

Objective: To present the objectively assessed very long-term results of a prospective study of 149 patients with achalasia of the cardia who underwent Heller myotomy and posterior partial fundoplication.

Summary Background Data: Very few studies evaluate objectively the very long-term results to analyze whether the effectiveness of Heller myotomy is maintained with the passing of time.

Methods: The study group consisted of 149 patients who underwent a Heller myotomy plus a posterior partial fundoplication through a laparotomy.

[Surgical treatment of high-grade dysplasia in Barrett's esophagus].

Introduction: Barrett's esophagus undergoes malignant transformation in 0.5-1% of patients per year following the sequence of low-grade dysplasia, high-grade dysplasia and adenocarcinoma. The aim of the present study was to present our experience in the surgical treatment of Barrett's esophagus with high-grade dysplasia.

Severe acute lower gastrointestinal bleeding: risk factors for morbidity and mortality.

Background: Many factors can cause morbidity and mortality in patients with severe acute lower gastrointestinal bleeding (LGIB). The objectives of this study are to analyze three aspects related to severe acute LGIB: (1) indications and prognostic factors for urgent surgery, (2) risk factors for morbidity and mortality, and (3) relapse rates.

Patients And Methods: A retrospective cohort was collected between 1985 and 2002 in a tertiary referral center.

[Esophageal tuberculosis].

Primary esophageal tuberculosis is virtually non-existent and there are few cases described of secondary esophageal tuberculosis. Esophageal tuberculosis should be suspected in patients with dysphagia, positive test results for tuberculin, active pulmonary disease or mediastinal adenopathies. Endoscopic or x-ray images could be indistinguishable from esophageal carcinomas, hence a diagnosis can prevent wrong treatments.

Acute lower gastrointestinal hemorrhages in geriatric patients.

Age is a risk factor in acute lower gastrointestinal hemorrhages (LGIH). The objectives here were to analyze: (1) diagnostic and therapeutic handling, (2) related morbidity and mortality, (3) the indications for surgery, and (4) the evolution of acute LGIH in patients > or =80 years. Forty-three patients >80 years with acute LGIH were reviewed retrospectively.

Long-term results of a randomized prospective study comparing medical and surgical treatment of Barrett's esophagus.

Objective: To compare the results of medical treatment and antireflux surgery in patients with Barrett's esophagus (BE).

Summary Background Data: The treatment of choice in BE is still controversial. Some clinical studies suggest that surgery could be more effective than medical treatment in preventing BE from progressing to dysplasia and adenocarcinoma.