Clinical and economic burden of varicella in pediatric patients hospitalized in four institutions in Guatemala.

Varicella presents a public health challenge in Guatemala, with limited evidence regarding its impact; vaccine is currently absent from the national immunization program. Generating local data on the economic and health burden can support immunization policies. This study describes the use of hospital resources, costs of care, clinical and demographic characteristics, and complications in children with varicella.

Autoimmunity against cytokines: Double strike in autoimmune disease, a historical perspective.

Autoimmune responses are characterized by the development of antibodies and the activation of T lymphocytes against self-antigens. This leads to an effector immune response against tissues expressing antigens, which are later recognized by the host immune system. Host antigens attacked by antibodies are called "autoantigens" and are of different kinds, including receptors, enzymes, and channel proteins.

[Assessment of corticosteroid use as a marker of quality-of-care in the management of inflammatory bowel disease].

Introduction: Despite advancements in therapeutic strategies, corticosteroids continue to play a role in inducing remission in Inflammatory Bowel Disease (IBD). Unfortunately, these drugs are often misused.

Objectives: To assess the dose and duration of corticosteroid therapy,and the subsequent change in treatment among patients with IBD.

Cardio-Obstetrics Practice in Latin America: A Regional Survey of General Cardiologists.

Background: Cardiovascular (CV) disease is a leading cause of death in pregnant women globally, especially in low- and middle-income countries including Latin America (LATAM), where there is lack of data on how cardiologists are trained in cardio-obstetrics (CO) and the practice patterns in the care of pregnant patients.

Objectives: The authors aimed to identify CO competency and practice patterns among LATAM general cardiologists.

Methods: An anonymous cross-sectional Google-based electronic survey was sent via email to clinical cardiologists through local American College of Cardiology chapters and CV societies.

Empirical antibiotic therapy improves outcomes in mechanically ventilated patients with COVID-19: An emulated targeted trial within a prospective, multicentre cohort study.

Background: Bacterial pulmonary superinfections develop in a substantial proportion of mechanically ventilated COVID-19 patients and are associated with prolonged mechanical ventilation requirements and increased mortality. Albeit recommended, evidence supporting the use of empirical antibiotics at intubation is weak and of low quality. The aim of this study was to elucidate the effect of empirical antibiotics, administered within 24 h of endotracheal intubation, on superinfections, duration of mechanical ventilation, and mortality in mechanically ventilated patients with COVID-19.

Vascularized Periosteal Grafts for Bone Union in Children: A Systematic Review.

Background: The periosteum is the main organ responsible for bone regeneration. Vascularized Periosteal Grafts (VPG) have demonstrated exceptional efficacy and speed in facilitating bone union among children with challenging bone healing conditions. Despite their promising results, the overall impact of these interventions has yet to be comprehensively evaluated through systematic review.

Real-World Treatment Outcomes of an Artificial Tear Containing Arabinogalactan, Hyaluronic Acid and Trehalose Among Subjects with Dry Eye.

Purpose: To assess the efficacy, adherence, and tolerability of a new artificial tear based on arabinogalactan, hyaluronic acid, and trehalose in a population with dry eye disease (DED).

Methods: A retrospective, real-world, post-marketing study identified 96 adult patients (aged 18-80 years) with signs and symptoms of dry eye. These patients received fixed combination therapy with eye drops containing arabinogalactan, hyaluronic acid, and trehalose at various dosing schedules.

Nutritional Status in Locally Advanced or Metastatic Solid Cancer Patients Treated With Chemotherapy, Radiotherapy, and Immunotherapy in Spanish Outpatient Oncology Units.

Objectives: Malnutrition is a prevalent condition in cancer patients that significantly impacts patients' clinical outcomes and health-related quality of life (HR-QoL). The outcome was to characterize the nutritional status by describing the prevalence of malnutrition (mild, moderate, or severe) and its risk in outpatient cancer patients.

Methods: Multicenter, prospective, cross-sectional, descriptive, two-cohort study conducted on consecutive adult patients with locally advanced or metastatic solid tumors (stages III-IV).

Infection Relapse and Time-to-Healing After Conservative Surgery for Non-Acute Presentations of Diabetes-Related Forefoot Osteomyelitis: Does Site Matter?

Diabetes-related foot osteomyelitis (DFO) can present as an acute condition with soft tissue involvement or as a non-acute form characterized by long-standing ulcers without immediate limb-threatening features. This study evaluates infection relapse and healing times after conservative surgery in non-acute DFO, with a focus on osteomyelitis localization. A retrospective cohort of 60 patients treated for forefoot DFO without soft tissue involvement or necrosis was analyzed.

Understanding the Epidemiology of Monkeypox Virus to Prevent Future Outbreaks.

Monkeypox (Mpox) is an infectious disease caused by the Mpox virus belonging to the Orthopoxvirus genus in the Poxviridae family and has been declared by the WHO as a global health emergency owing to its rapid spread during 2022 and 2023. All patients diagnosed with Mpox who were confirmed by PCR between July 2022 and April 2023 were included in this study. In total, 405 patients in whom clade 2 was identified were included.

Inbreeding and Gallbladder Cancer Risk: Homozygosity Associations Adjusted for Indigenous American Ancestry, BMI, and Genetic Risk of Gallstone Disease.

Latin Americans have a rich genetic make-up that translates into heterogeneous fractions of the autosomal genome in runs of homozygosity (F) and heterogeneous types and proportions of indigenous American ancestry. While autozygosity has been linked to several human diseases, very little is known about the relationship between inbreeding, genetic ancestry, and cancer risk in Latin Americans. Chile has one of the highest incidences of gallbladder cancer (GBC) in the world, and we investigated the association between inbreeding, GBC, gallstone disease (GSD), and body mass index (BMI) in 4029 genetically admixed Chileans.

[Screening in Cystic Fibrosis in the Chilean population. Pilot project for screening in newborns].

Unlabelled: Neonatal screening has been implemented internationally with different protocols and has become the routine method in the preclinical stage. Late diagnosis is associated with more severe symptoms with decreased survival and higher treatment costs.

Objectives: To estimate the incidence of cystic fibrosis; to evaluate the performance of the screening algorithms Immunoreactive Trypsinogen and Pancreatitis-Associated Protein (IRT/PAP) and the IRTxPAP product; to analyze the cut-off value for IRT, PAP, and IRTxPAP, and to establish a methodology for its ongoing evaluation; finally, to evaluate the quality of IRT and PAP measurements.

[Health Related Quality of Life in retinoblastoma patients].

Unlabelled: Retinoblastoma (Rb) is the most common intraocular cancer in children and, along with its treatment, can negatively impact the Quality of Life (QoL). Few studies have explored this subject in these patients; none in Latin America.

Objective: To evaluate the general, physical, emotional, social, and school quality of life of patients treated for Rb and to analyze which patient, disease, or treatment factors are associated with worse outcomes.

[Translated article] Multicenter Analysis of the Surgical Management and Adjuvant Therapy of Patients With Melanoma and a Positive Sentinel Lymph Node Biopsy.

Introduction: Complete lymph node dissection (CLND) was the standard practice for patients with melanoma and a positive sentinel lymph node biopsy (SLNB) until the results of two clinical trials published in 2016 and 2017 demonstrated that it did not improve melanoma-specific survival (MSS). However, it continues to be performed in some scenarios. No studies have ever been published on lymph node management after a positive SLNB in the routine clinical practice in our setting.

Technological Innovations to Support Family Caregivers: A Scoping Review.

Introduction: Population aging increases the risk of dependency among older adults, which in turn necessitates care, primarily provided by family caregivers. This situation leads to physical and emotional strain on these caregivers. New technologies, such as tele-education, digital platforms, or mobile applications, can offer an accessible and equitable alternative for caregiver training and self-care support.

Continuation of CDK4/6 Inhibition and Switching of Hormonal Therapy After Progression on Prior CDK4/6 Inhibitors in HR+/HER2- Breast Cancer: A Systematic Review and Meta-Analysis.

This study aims to determine the efficacy of maintaining cyclin-dependent kinase 4/6 (CDK4/6) inhibition and switching endocrine therapy (ET) versus ET alone after progression on prior CDK4/6 inhibitors (CDK4/6i) in patients with hormone-receptor-positive, human epidermal growth factor receptor-2-negative breast cancer. We identified phase II and III comparative randomized clinical trials through a systematic search across relevant clinical databases. A random effects model was used to determine the pooled hazard ratio (HR) for progression-free survival (PFS) according to the inverse-variance method.

Conservative surgery for forefoot osteomyelitis may increase reulceration-free survival compared to minor amputation in diabetes-related foot disease.

This study suggests that conservative surgery may improve reulceration-free survival in patients with diabetes-related forefoot osteomyelitis, compared to minor amputation. By excluding patients with prior surgeries, the analysis more accurately reflects the benefits of conservative surgery. These findings highlight the importance of preserving foot structure to maintain biomechanics and reduce reulceration risk.

Analysis of the progression of cervical cancer in a low-and-middle-income country: From pre-malignancy to invasive disease.

To better understand cervical cancer progression, we analyzed RNA from 262 biopsies from women referred for colposcopy. We determined the HPV type and analyzed the expression of 51 genes. HPV31 was significantly more prevalent in precancer than stage 1 cancer and invasive cancer (p < 0.

[Advances in continuous glucose monitoring: evidence of a new generation technology].

Continuous glucose monitoring (CGM) provides comprehensive and dynamic information to guide the management of diabetes mellitus (DM). This paper summarizes the evidence and implications of the use of the new CGM system, FreeStyle Libre 2 (FSL2). A global review of the literature on the use of FSL2 in people with DM was performed.

Aplastic Anemia: Demographic and Clinical Characteristics in Costa Rica.

Background Aplastic anemia (AA) is a rare and heterogeneous hematological disorder defined as pancytopenia with hypocellular bone marrow in the absence of abnormal infiltration or medullary fibrosis. Various causes of AA have been identified, such as autoimmune factors, bone marrow injuries, viral infections, and genetic disorders. The symptoms of AA are directly linked to pancytopenia and the most common are fatigue, recurrent infections, and bleeding problems.

The successful implementation of Stop the Bleed in Guatemala.

Objective: This project aimed to successfully implement the Stop the Bleed (STB) program in Guatemala by targeting key providers in various communities across the country.

Setting: The course was conducted in rural community centers, fire stations, tertiary care centers, and medical school facilities.

Participants: We included agricultural occupational health workers, firefighters, medical providers, and medical students throughout the course.

Dual trajectories of polypharmacy and medication regimen complexity index in people living with HIV in Spain.

Background: Polypharmacy, using 6 or more medications, may increase the risk of high medication regimen complexity index (MRCI). We aimed to identify the interrelationship between trajectories of polypharmacy and MRCI.

Methods: People living with HIV (PLWH) (aged ≥18) were included in from 2010 to 2021.

Smartphone-Enabled Point-of-Care Testing for Prehospital Stroke Diagnosis.

Objectives: The objective of this study was to evaluate the feasibility of point-of-care testing (POCT) devices for N-terminal pro-B-type natriuretic peptide (NT-proBNP) measurement in prehospital settings, with the aim of improving the speed and accuracy of stroke diagnosis, thereby facilitating quicker and more effective patient care.

Methods: Prehospital blood samples were collected from suspected stroke patients, and NT-proBNP levels were measured using a POCT device in ambulances and hospitals. Results from the NT-proBNP POCT and smartphone images were analyzed.