South Health and Policy (Journal)
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Type II Diabetes: The New Risk Factor for Alzheimer’s Disease
No full textBackground: Type 2 Diabetes Mellitus (T2DM) is a chronic disease prevalent in older adults, associated with cita microvascular and macrovascular complications. Recent studies suggest a link between T2DM and an increased risk of dementia, particularly Alzheimer’s disease. The main hypothesis of this study suggests that inflammation and alterations in glucose metabolism, characteristics of T2DM, may contribute to the development of Alzheimer’s pathology. Material and methods: A systematic review was conducted on studies investigating the relationship between T2DM and Alzheimer’s disease. Observational studies examining patients with T2DM, and a confirmed diagnosis of cognitive impairment or Alzheimer’s disease were included. Searches were performed in databases such as PubMed and Google Scholar, with articles published between 2000 and 2024. Results: Out of 29 studies found, 4 relevant articles were selected. The data reveals a significant association between T2DM and an increased risk of cognitive impairment in older adults, highlighting mechanisms such as microcirculatory damage, β-amyloid accumulation, and cerebral insulin resistance. Additionally, it was found that systemic oxidative stress is lower when both diseases coexist, which may be related to a lower cognitive decline compared to patients suffering from only one of the two diseases. Conclusion: The systematic review confirms a significant relationship between T2DM and Alzheimer’s disease, supporting the hypothesis that metabolic processes and insulin resistance are key factors in the progression of cognitive decline. The findings suggest that when both diseases coexist, systemic oxidative stress is moderated, opening new areas of research on protective or modulatory mechanisms. However, additional studies are needed to confirm causality and explore specific interventions that reduce the risk of Alzheimer’s in T2DM patients
Antimicrobial resistance crisis in Latin American ICUs
No full textHealthcare-associated infections represented a growing challenge in hospitals, especially in intensive care units, where patients were more vulnerable. In this context, multi-resistant microorganisms made treatment difficult and increased health risks. In Latin America, antimicrobial resistance reached alarming levels due to the indiscriminate use of antibiotics, lack of control and surveillance, and limited health infrastructure. Pathogens such as Klebsiella pneumoniae KPC, Acinetobacter baumannii, Pseudomonas aeruginosa, ESBL-producing enterobacteria and MRSA were frequently identified in ICUs. This situation increased mortality, length of hospitalisation and the use of high-cost antibiotics. The response to this crisis required programmes for antimicrobial optimisation, infection control and strengthening of epidemiological surveillance
Health strategies against multi-drug resistant tuberculosis in the Argentine context
No full textIntroduction:Since 2010, Argentina has faced significant challenges in tackling multidrug-resistant tuberculosis (MDR-TB), especially in adolescents and children. Despite the legal framework established by National Law No. 24,695, inequalities persisted in the application of public policies, hindering the prevention, diagnosis and treatment of this disease throughout the country.Development:The epidemiological situation of MDR-TB worsened due to therapeutic abandonment, the inappropriate use of antibiotics and the limited availability of rapid diagnostics. Although tools such as GeneXpert and Genotype MTBDRplus were incorporated, their coverage was limited. In terms of treatment, Argentina adopted standardized regimens recommended by the WHO, but these proved to be lengthy and ineffective in pediatric populations. The use of modern drugs such as bedaquiline and linezolid was promoted, although access to them was restricted. The specific needs of children and adolescents were not adequately addressed, despite the enactment of Law No. 26,061. On the other hand, Resolution No. 680/2022 promoted shorter and oral regimens, and the psychosocial impact of treatment was recognized, although without concrete comprehensive strategies.Conclusion: Although regulatory and technical advances have been made, Argentina still needs to consolidate effective policies to guarantee an equitable approach to MDR-TB in vulnerable populations. Only a coordinated strategy, based on scientific evidence and rights, will be able to transform the management of drug-resistant tuberculosis and ensure universal access to healthcare
Hemophagocytic syndrome associated with dengue ¿what is the cause?
No full textIntroduction: Hemophagocytic syndrome (HS) is a dysregulated immune response that causes severe systemic inflammation and can arise from a variety of conditions, including viral infections such as dengue. Although its immunological process has been studied, diagnostic and treatment protocols remain unclear, affecting patient survival and prognosis. Methodology: A descriptive and retrospective study reviewing the literature of the last two decades to identify consensus on the causal relationship between HS and dengue. Fourteen articles were selected that demonstrated a causal relationship between the pathophysiological mechanisms of HS and dengue in pediatric and adult patients. Results: A consensus was reached associating the uncontrolled inflammatory response of HUS with the pathophysiological processes of dengue in any of its stages, confirmable by studies (laboratory and anatomopathological), its relationship with risk factors to optimize treatments and prognosis. Conclusion: Dengue in any of its stages can be a cause of HUS, but it is not the only entity capable of generating it
Bibliographic Review on Compartment Syndrome: Critical Evaluation of the 6 P\u27s, Diagnostic Methods and Treatment Algorithms in Unconscious Patients
No full textBackground: The diagnosis of compartment syndrome (CS) traditionally relies on the clinical assessment of the “6 P’s” (pain, paresthesia, pallor, pulse, paralysis, and pressure). However, this subjective assessment poses limitations in unconscious patients, where communication ability is absent.Material and methods: A review of recent studies was conducted to evaluate the validity of the “6 P’s” and the incorporation of intracompartimental pressure measurement as an objective diagnostic method. Results: The reviewed literature indicates that intracompartimental pressure measurement is effective for the early identification of CS, particularly in high-risk patients and contexts with uncertain clinical signs.Conclusion: The integration of continuous monitoring devices and the standardization of cut-off values can improve diagnostic accuracy and reduce errors in the management of CS in unconscious patients
Efficacy of Dietary Interventions and Probiotic Use in the Management of Gastrointestinal Disorders in Older Adult
No full textBackground: Older adults experience physiological changes and alterations in the gut microbiota that can significantly impact gastrointestinal health. These changes, alongside the high prevalence of digestive disorders in this population, underscore the need for targeted interventions to improve well-being. Dietary modifications and probiotic supplementation have emerged as promising strategies for managing these symptoms; however, further research is needed to fully understand their effectiveness in this age group. Materials and Methods: A literature search was conducted in databases such as PubMed and the Cochrane Library, focusing on studies published in the last 20 years. Studies examining the relationship between dietary changes, probiotic use, and gastrointestinal disorders in older adults were included. Data analysis was performed using a qualitative and descriptive approach, integrating and evaluating information from the selected studies. Statistical analysis was deemed unnecessary due to the heterogeneity of the studies or the nature of the results, with a focus on evaluating and integrating the available evidence. Results: Probiotics such as Lactobacillus rhamnosus GG, Bifidobacterium, and mixtures like VSL#3 were shown to reduce intestinal inflammation, improve gut microbiota, and relieve gastrointestinal symptoms, including abdominal pain, bloating, and constipation, in older adults. In some studies, probiotics were found to be comparable to standard medications like mesalazine in the treatment of ulcerative colitis. Conclusion: Probiotic use and dietary interventions are promising approaches for improving gastrointestinal disorders in older adults. These interventions not only enhance gut health but could also reduce polypharmacy and improve quality of life. Nevertheless, despite encouraging findings, further well-designed studies are required to better understand the mechanisms involved and to determine the most effective strategies for sustainably enhancing gastrointestinal health in older adults.
The role of general practitioners in the management of acute myocardial infarction in resource-limited settings
No full textAcute myocardial infarction with ST-segment elevation (STEMI) was one of the leading causes of death in Argentina and constituted a medical emergency requiring rapid and effective intervention. Timely care significantly reduced mortality, although challenges persisted in both the prehospital and hospital settings, especially in areas with limited resources. The annual incidence was 128 cases per 100,000 inhabitants, with a hospital mortality rate of 9% and a prehospital mortality rate of 91%. General practitioners played a key role in the diagnosis and initial treatment of STEMI, highlighting the need for training in ECG interpretation, reperfusion options, drug administration, and coordinated work with emergency services. Although primary coronary angioplasty was the treatment of choice, prehospital thrombolysis was used as an alternative in regions with poor infrastructure. Strategies such as ongoing training, the development of care networks, the standardisation of prehospital protocols and the use of technologies such as telemedicine were proposed to overcome the structural barriers of the Argentine health system
Impact of endometriosis on female fertility: evidence and challenges in Argentina
No full textEndometriosis was identified as a chronic, common and underdiagnosed gynecological condition affecting between 10% and 20% of women of reproductive age and closely associated with infertility. Between 30% and 50% of those who suffered from it faced difficulties conceiving, which reflected the complexity of its impact on reproductive health, especially in Latin America.This study carried out a systematic literature review that allowed for an analysis of the relationship between endometriosis and infertility, identifying proposed pathophysiological mechanisms, such as hormonal, immunological and anatomical alterations. Despite these advances, there was still a lack of consensus on the exact mechanisms involved and on the effectiveness of available treatments, such as laparoscopic surgery and hormone therapies, whose results were variable and contradictory.The work was contextualized in the Argentine scenario between the years 2020 and 2024, a period marked by the COVID-19 pandemic and an increased visibility of sexual and reproductive rights. However, endometriosis remained absent from the public agenda, and difficulties in early diagnosis and access to specialized treatments continued to affect thousands of women.It was concluded that there is an urgent need to strengthen research, improve medical training and develop public policies that include endometriosis as a priority within reproductive health, in order to guarantee comprehensive care that improves the quality of life of the women affected
Pharmacological management of acute confusional state in Latin America
No full textAcute confusional syndrome (ACS) was described as an acute and fluctuating mental disorder, common in older adults hospitalised in Latin America. The pharmacological use of haloperidol and benzodiazepines in its treatment was analysed. Haloperidol was widely used due to its efficacy and low cost, although warnings were given about its adverse effects, such as extrapyramidal symptoms and arrhythmias. Benzodiazepines were reserved for cases of alcohol withdrawal due to their cognitive and respiratory risks. The importance of monitoring, prevention and staff training protocols was emphasised in order to improve the management of ACS in the region
Progress in health policies on CBD in Argentina and MERCOSUR
No full textCannabidiol (CBD), a compound derived from cannabis, was considered a promising therapeutic option for treating refractory epilepsy. It was shown that, when combined with conventional treatments, it significantly reduced seizures in syndromes such as Dravet, Lennox-Gastaut and Tuberous Sclerosis. In Argentina, its benefits were recognised and public policies were implemented to facilitate access, with the authorisation of the ANMAT and programmes of the Ministry of Health. At a regional level, MERCOSUR promoted joint strategies to improve access to high-cost medicines. However, serious adverse effects were observed, making strict medical supervision necessary. In general, CBD represented a relevant therapeutic alternative, although the need for further research into its safety and efficacy was emphasised.