South Health and Policy (Journal)
Not a member yet
234 research outputs found
Sort by
Medical training and clinical response in the management of STEMI from the first level of care
No full textThe limitations faced by primary care in addressing ST-segment elevation myocardial infarction (STEMI), one of the leading causes of death worldwide. Early diagnosis and treatment were highlighted as key to improving patient prognosis, but obstacles persisted, such as insufficient training of medical personnel, lack of resources, and the absence of standardised protocols. Various studies showed that many doctors were not adequately prepared to recognise and treat STEMI effectively, a situation exacerbated by deficiencies in practical medical education, especially during the pandemic. The need to strengthen clinical training, adequately equip health centres and establish integrated networks to ensure rapid access to reperfusion treatments was also highlighted. The study concluded that only a comprehensive approach would improve the healthcare response to this critical emergency
Impact of trauma and healthcare response to frontotemporal dementia
No full textFrontotemporal dementia is a neurodegenerative disease that mainly affects the frontal and temporal lobes of the brain, causing changes in behaviour, personality and language. Although its cause was mainly genetic, traumatic events were also considered to act as triggers or accelerators of its clinical onset. In Latin America, particularly in Argentina, Brazil, and Uruguay, this relationship has become especially relevant due to population ageing, stigmatisation, and deficiencies in mental health systems. In Argentina, the lack of a specific national plan hampered comprehensive care; Brazil implemented community-based policies, albeit with regional inequalities; and Uruguay led regional cooperation efforts but still faced limitations in specific policies for dementia. It was concluded that public strategies including prevention, early diagnosis and support for caregivers needed to be developed
Impact of contrast agents on renal function: A systematic review
No full textBackground: Radiological contrast agents are essential for obtaining accurate medical images; however, their use carries a significant risk of nephrotoxicity, a complication that can lead to acute kidney injury (AKI). This systematic review aims to assess the impact of iodinated and gadolinium-based contrast agents on kidney function, comparing their relative risk of inducing contrast-induced nephropathy (CIN). Objectives: To evaluate the impact of radiological contrast agents on renal function. Material and methods: A systematic review of the literature available in databases such as PubMed and Google Scholar were conducted. Observational studies controlled clinical trials, meta-analyses, and systematic reviews published between 2009 and 2024 that evaluated the impact of iodinated and gadolinium-based contrast agents in adult patients undergoing imaging studies were included. Results: The review indicated that the incidence of contrast-induced nephropathy (CIN) varies according to the type of contrast agent and patient conditions. In populations without risk factors, the incidence of CIN was low, while in patients with chronic kidney disease or diabetes, the incidence was significantly higher (up to 12%). No significant differences were observed between iodinated and gadolinium-based contrast agents in terms of CIN risk. In patients with renal insufficiency, proper hydration, combined with other measures such as the use of nitrates, was highlighted as the most effective preventive strategy. There was no clear benefit of N-acetylcysteine in reducing CIN. Overall, intravenous hydration remains the key preventive measure to reduce CIN risk. Conclusion: The literature review indicates the need for more rigorous clinical trials to assess the efficacy and safety of different contrast agents. It highlights the importance of a thorough assessment of individual risk factors to minimize nephrotoxicity in patients undergoing contrast-based procedures
Analysis of the Effectiveness and Safety of the Fentermine and Topiramate Association in Obesity: A Systematic Review of the Literature
No full textBackground: Obesity is a chronic disease characterized by excessive calorie consumption, leading to fat storage, and can manifest at any stage of life, with prevalence increasing progressively over the years, contributing to other health problems such as diabetes, cardiovascular diseases, and even certain types of cancer. The imminent global prevalence of obesity has emphasized the need for weight loss methods, including dietary adjustments, physical activity, and pharmacological therapy, which has significantly improved weight loss in individuals with obesity and overweight. Fentermina is a medication used to aid adolescents and adults with obesity who have not achieved sufficient weight loss through conventional methods such as diet and exercise. It acts as an appetite inhibitor by releasing dopamine and noradrenaline. Topiramate, a D-fructose derivative anticonvulsant, has a mechanism of action that is not yet fully understood, but it is known for its anticonvulsant action and participation in treating compulsive eating disorders, overweight, and obesity.Material and methods: A systematic review of the literature was conducted based on clinical trials and randomized controlled trials to collect publicly available information. The search was carried out thoroughly in four different search engines/databases: PubMed, Cochrane Library, Scopus, Google Scholar, and Web of Science. All identified publications were carefully examined and analyzed to ensure the quality and relevance of the collected information.Results: The literature review yielded a total of 21 references, of which 11 met the inclusion criteria. The research articles provided moderate evidence that the combination of Fentermina and Topiramato is effective and safe for obesity treatment. A gradual decrease in body weight was observed in patients from the beginning of treatment up to 20 weeks post-treatment. Additionally, notable secondary results were found, such as changes in blood pressure, triglyceride levels, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, and hemoglobin A1C levels from the beginning of treatment. Conclusion: The recommended doses for long-term weight control in adults are 3.75 mg, 7.5 mg, and 15 mg for Fentermina and 23 mg, 46 mg, and 92 mg for Topiramato. If a 5% weight loss is not achieved after 12 weeks with this dose, its use should be reconsidered
Clostridioides difficile infection: A growing threat in Argentine hospitals
No full textThe study addressed Clostridioides difficile infection (CDI) as one of the main causes of nosocomial diarrhea in hospitalized patients, especially in older adults and people with comorbidities. We analyzed how the prolonged and inadequate use of antibiotics altered the intestinal microbiota, facilitating colonization of the bacillus. Likewise, the main risk factors were described, including prolonged hospitalization, exposure to broad-spectrum antimicrobials and stay in intensive care units. In the Argentine context of the year 2024, there was a lack of standardized epidemiological data, difficulty in accessing sensitive diagnostic methods and unequal implementation of preventive measures among institutions. The Argentine health system, which was affected by structural tensions, economic limitations and institutional fragmentation, showed difficulties in controlling the spread of CDI, resulting in increased morbidity, prolonged hospitalization and higher hospital costs. Despite these limitations, the study highlighted the importance of strengthening epidemiological surveillance, promoting the rational use of antibiotics, training health personnel and improving infection control programs. Finally, it was concluded that a multidisciplinary approach, supported by sustained health policies and coordinated actions between the public and private sectors, was essential to reduce the incidence of this infection in Argentina and to improve clinical outcomes in vulnerable patients.
Frontotemporal dementia: post debut exposure to a traumatic evento
No full textIntroduction: A traumatic event can forever alter the course of a life. This was the case for a 71-year-old patient who, after experiencing a profoundly impactful event, began to develop symptoms of post-traumatic stress disorder (PTSD). Over time, these symptoms evolved into something even more devastating: a diagnosis of frontotemporal dementia. This case inspired the present investigation, as PTSD has been identified as a potential risk factor for the development of various types of dementia, particularly frontotemporal dementia. Materials and Methods: A systematic literature review was conducted to explore the relationship between PTSD and dementia. Additionally, a detailed case analysis of a patient who suffered from PTSD and was subsequently diagnosed with frontotemporal dementia was included to illustrate this potential connection. Results: The reviewed studies suggest that PTSD is associated with an increased risk of developing frontotemporal dementia, especially when the individual has been exposed to prolonged stress. Psychiatric factors such as depression and anxiety emerged as important mediators in this relationship. The clinical case aligns with the studies, showing an early and rapid onset of dementia symptoms following the traumatic event. Conclusion: There is a complex relationship between PTSD and the early onset of dementia, highlighting the importance of comprehensive and timely diagnostic and therapeutic approaches. Further research is needed to better understand the mechanisms underlying this connection, allowing for the development of early interventions that could prevent or slow long-term cognitive decline
Progress and challenges in the implementation of PrEP in Latin America
No full textPre-exposure prophylaxis (PrEP) has become a key tool in HIV prevention in Latin America, although its implementation has been uneven across countries. Brazil led the way in 2017, focusing on high-risk populations such as men who have sex with men and transgender women. Argentina integrated PrEP into its combined prevention strategy through specialised centres and clinical guidelines. Uruguay developed specific guidelines and pilot programmes, while Chile focused on studies and training. Bolivia and Paraguay recently began incorporating PrEP into their public health systems, facing challenges in data collection and access. PrEP use was associated with both a possible increase in risky sexual behaviour and earlier detection of STIs thanks to frequent access to health services. Low coverage and factors such as stigma, lack of knowledge, and infrastructure limitations were common obstacles. Despite this, PrEP proved to be an effective strategy for reducing HIV, underscoring the need for sustainable and inclusive public policies to expand its impact in the region
Social and structural challenges in the implementation of PrEP
No full textPre-exposure prophylaxis (PrEP) was considered a crucial advance in HIV prevention, especially in high-risk populations. Its use proved highly effective in significantly reducing virus transmission, although its implementation presented multiple challenges. Adherence to treatment was found to be key to its effectiveness, but it was also linked to an increase in sexually transmitted infections, attributed to changes in risk behaviours. In addition, inequalities in access were identified, mainly in rural and marginalised areas of Latin America. Mental health and training for healthcare personnel were also key factors in the sustainability of the programme. Finally, it was concluded that further research was essential to adapt this strategy to different cultural and social contexts
Presence of PIK3CA mutation in patients with stage IV luminal breast cancer and its relationship with rapid progression
No full textBackground: Breast cancer is a disease of the mammary gland in which its cells grow and multiply abnormally. In Argentina, there were around 131,000 new cases of cancer, of which approximately 22,000 cases were of breast origin (2020). Although survival is increasing and its mortality rate is constantly decreasing due to great advances, in this work we will mention certain aspects related to rapid progression, increased mortality and lack of response to treatments that are associated with specific genetic mutations. We will address the PIK3CA pathway; one of the most active pathways in breast cancer, its relationship with the prognosis of the disease, resistance mechanisms and response to current treatments. Materials and methods: We will rely on academic literature, publications and our own experiences regarding this pathology, taking 23 patients with stage IV luminal breast cancer from the Lucen Clinic and the Marie Curie Hospital between 1998 and 2001. Results: 10 of them had the mutation in the PIK3CA pathway (43%) and 13 did not (57%). In addition to this, we will evaluate the survival time of the patients by comparing both groups; obtaining results that those who had this mutation had a lower average survival time, around 5-6 months, details that will be analyzed later. Conclusion: Therefore, we will conclude that metastatic breast cancer in stages IV that have the mutation of this gene will have a worse prognosis in terms of their quality of life, due to the chemoresistance generated by having the mutated PIK3CA pathway
Hematology: A comprehensive approach to study and practice
No full textBlood is a very particular tissue, which has numerous properties. Hematologic diseases encompass a wide range of conditions, including anemias, coagulation disorders, leukemias, lymphomas, and myelomas. Hematology is a vital field that not only focuses on diseases, but has a significant impact on the individual\u27s individual health. The continuous evolution of knowledge and techniques in this discipline promises to improve clinical outcomes and patients\u27 quality of life. General objective: Provide a comprehensive and up-to-date understanding of the components, functions and disorders of blood, as well as the diagnostic methods and treatments available. Aim. Describe a complete approach to study and practice. The methodology used for this research work is framed within a documentary-type bibliographic review, since we are going to deal with topics raised at a theoretical level such as Pediatric Hematology and the most frequent disorders. The technique for data collection consists of electronic materials, the latter such as Google Scholar, PubMed, Science direct, among others, descriptors in health sciences were used. Based on the bibliography found Conclusions: The Article offers a comprehensive and updated vision of blood and its diseases. This resource is essential for health professionals and students. Promoting an evidence-based approach