Medwave最新文献

{"title":"Cultural adaptation to Shawi and psychometric analysis of the Patient Health Questionnaire (PHQ-9) in adults from the Alto Amazonas, Peru.","authors":"Lariza Calderón-Delgado, Luis Fernando Segura-Muñoz, Silvana Maria Figueroa-Toribio, Julio Cjuno","doi":"10.5867/medwave.2026.04.3176","DOIUrl":"https://doi.org/10.5867/medwave.2026.04.3176","url":null,"abstract":"<p><strong>Introduction: </strong>Depression is currently one of the most impactful mental health conditions worldwide, with more than 280 million reported cases. However, there is a critical lack of data on Indigenous populations due to language barriers and the absence of culturally adapted assessment tools, limiting timely diagnosis and appropriate care. The aim of this work is to culturally and linguistically adapt the Patient Health Questionnaire-9 (PHQ-9) into the Shawi language and to evaluate its psychometric properties among Indigenous adults in Alto Amazonas, Peru.</p><p><strong>Methods: </strong>A rigorous cultural adaptation process was carried out, including translation by bilingual experts and back-translation. Validation involved expert technical review and a pilot phase conducted within the participating community. Content validity was assessed using Aiken's V coefficient as a statistical indicator. The internal structure was evaluated using confirmatory factor analysis and structural equation modeling.</p><p><strong>Results: </strong>The sample consisted of 432 members of the Shawi community. The instrument showed excellent content validity (V = 0.90 to 1.00). Confirmatory factor analysis supported a unidimensional model with good fit (comparative fit index: 0.98; root mean square error of approximation: 0.06) and adequate internal consistency (α = 0.80; ω = 0.81). In addition, invariance of the PHQ-9 was demonstrated across age, sex, educational level, and marital status, supporting its applicability across different population subgroups.</p><p><strong>Conclusions: </strong>The Shawi version of the Patient Health Questionnaire-9 has proven to be a reliable and valid tool for detecting depressive symptoms in this Indigenous population. This advancement represents a significant contribution to reducing mental health disparities by facilitating culturally appropriate diagnoses and improving care in historically underserved Amazonian communities.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 4","pages":"e3176"},"PeriodicalIF":0.8,"publicationDate":"2026-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Temporal trends in cancer incidence in a Peruvian population of the Social Health Insurance between 2000 and 2020.","authors":"Richard Ponce-Cusi, Edwin Lázaro-Valdivia, María Del Pilar Urday-Huarilloclla, Grovert Quino-Villanueva, Nesstor Pilco-Ferreto, Claudio Flores, Yolanda Angulo-Bazán","doi":"10.5867/medwave.2026.04.3151","DOIUrl":"https://doi.org/10.5867/medwave.2026.04.3151","url":null,"abstract":"<p><strong>Introduction: </strong>Cancer is one of the leading causes of disease burden in Peru, with significant regional disparities in incidence and mortality. The Moquegua region has experienced a sustained increase in risk factors and cancer burden without systematic studies to characterize its epidemiological profile. The objective of this study was to estimate the temporal trend in cancer incidence and describe its characteristics in the population insured by Social Health Insurance in Moquegua between 2000 and 2020.</p><p><strong>Methods: </strong>A retrospective study was conducted based on institutional records of patients with cancer confirmed by pathological anatomy at Hospital Base II, Moquegua. Crude and age-adjusted incidence rates were calculated. Additionally, a joinpoint regression model was applied to analyze temporal trends. The analysis was stratified by sex and anatomical location. Furthermore, five-year overall survival was calculated for the most common neoplasms.</p><p><strong>Results: </strong>A total of 545 new cancer cases were identified during the study period. The overall age-adjusted incidence rate was 30.2 per 100 000 insured individuals, with a higher prevalence among women (55.2%). A significant upward shift was observed between 2013 and 2017. The most common sites were: breast (19.4%), prostate (18.0%), cervix (7.5%), colorectal (7.3%), and thyroid (7.0%). Breast cancer had the highest incidence rate; thyroid cancer had a survival rate close to 100%, while prostate cancer had the lowest overall survival rate.</p><p><strong>Conclusions: </strong>The incidence of cancer in Moquegua has shown an upward trend since 2013, possibly associated with improvements in diagnostic capacity. Rates were higher among women, with a predominance of neoplasms common at the national level. These findings underscore the need to strengthen cancer surveillance through a territorial approach and to improve access to early-diagnosis services and timely treatment.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 4","pages":"e3151"},"PeriodicalIF":0.8,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840178","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncommon combination of multifocal oncocytic adenomas and calcified colloid cystic goiter in the thyroid gland: A case report.","authors":"Selena Valeria Balarezo Chalco, Karla Maria Cumbe Guerrero, Jenniffer Nataly Quito Peralta, Rodrigo Salvador Puma Quito, Medardo Andrés Guzmán Cobos","doi":"10.5867/medwave.2026.03.3165","DOIUrl":"https://doi.org/10.5867/medwave.2026.03.3165","url":null,"abstract":"","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 3","pages":"e3165"},"PeriodicalIF":0.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Stigma and discrimination toward people living with HIV among healthcare workers in a public hospital in Mexico: A cross-sectional study.","authors":"Gerson Lugardo Vasquez Reyes, Melina Anaid Mendoza Flores","doi":"10.5867/medwave.2026.03.3122","DOIUrl":"https://doi.org/10.5867/medwave.2026.03.3122","url":null,"abstract":"<p><strong>Introduction: </strong>In the global context of the HIV pandemic, the biopsychosocial environment of key populations remains marked by a culture that fosters stigma and discrimination. These attitudes, based on misconceptions of what it means to live with HIV, transcend the healthcare sphere and negatively impact people's quality of life. In Mexico, systematic documentation of this issue within hospital settings remains limited. The objective of this study was to estimate the frequency of HIV-related stigma and discrimination among healthcare personnel of a secondary-level public hospital, as well as to identify differences by job category.</p><p><strong>Methods: </strong>We conducted an observational, descriptive, cross-sectional study from February to March 2025 at a secondary-level public hospital in Cancún, Quintana Roo, Mexico. We applied the short version of the HIV stigma questionnaire proposed by Nyblade et al. A total of 316 healthcare workers from different areas participated. To identify differences in stigmatizing attitudes across professional groups and to explore potential associations between sociodemographic variables and HIV-related beliefs, descriptive statistical analyses were performed, along with non-parametric tests (Kruskal-Wallis, Mann-Whitney U, and Spearman correlations) and post hoc comparisons using Dunn's test with Bonferroni correction.</p><p><strong>Results: </strong>A total of 22.5% of participants reported having witnessed refusal to work with people living with HIV, and 30.1% observed lower-quality care toward them. Additionally, 32.9% agreed that people living with HIV are irresponsible, and 30.4% believed they \"do not care about spreading the infection.\" Significant differences in stigma levels were found across occupational categories (p < 0.001). Medical assistants and interns showed higher levels of stigmatizing attitudes, while family physicians, nursing supervisors, and laboratory staff demonstrated greater empathy. Personally knowing someone living with HIV was significantly associated with greater acceptance of the right to become pregnant (p = 0.047).</p><p><strong>Conclusions: </strong>Stigma toward people living with HIV remains present in hospital environments. There is an urgent need to implement institutional training and awareness programs to reduce discriminatory attitudes and promote respect, accurate information, and empathy among all healthcare staff.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 3","pages":"e3122"},"PeriodicalIF":0.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147776141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Intrahepatic cholestasis of pregnancy in Chile: Analysis of epidemiological change and a microbiological hypothesis.","authors":"Cristian Contreras Vidal, Jorge Carvajal Cabrera","doi":"10.5867/medwave.2026.03.3161","DOIUrl":"10.5867/medwave.2026.03.3161","url":null,"abstract":"<p><p>Intrahepatic cholestasis of pregnancy is a gestational pathology with an unusual epidemiological and pathophysiological behavior that remains partially unexplained. Its current global incidence ranges from 0.1% to 2%. However, in Chile, the incidence reached up to 15% in the 1970s, with a marked decrease over subsequent decades, being nowadays about 1 to 2%. The reasons for this historical change are not fully understood. A literature-based analysis was conducted, focusing on clinical, microbiological, and epidemiological studies on intrahepatic cholestasis and other hepatobiliary diseases. The aim of this was to explore existing evidence and to propose a microbiological hypothesis that could help explain the epidemiological transition observed in Chile. Notably, the temporal reduction in incidence paralleled a nationwide decline in biliary disease and typhoid fever. We hypothesize that the eradication or significant reduction of certain pathogens, such as Typhi, may have contributed to the normalization of intrahepatic cholestasis of pregnancy rates in Chile.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 3","pages":"e3161"},"PeriodicalIF":0.8,"publicationDate":"2026-04-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147729532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Postmodern neuroses: Analysis from logotherapy.","authors":"Julio Cesar Suarez Luna, María Alejandra Bazan Marquez","doi":"10.5867/medwave.2026.02.3173","DOIUrl":"https://doi.org/10.5867/medwave.2026.02.3173","url":null,"abstract":"<p><p>This article on critical hermeneutic methodology conducted an exegesis on the emergence of new neuroses described in the academic fields of logotherapy, philosophy, and social psychology in postmodernity, focusing on sociogenic and noogenic (spiritual) factors. To this end, the objective was to conduct an analysis of postmodern neuroses from the perspective of logotherapy, with a focus on sociogenic and noogenic origins. Guided by an existential analysis, it is understood that these postmodern neuroses contribute to the proliferation of a silent psychosocial malaise that originates in postmodern ideologies. Thus, this study was conducted from a metaclinical and paraclinical perspective, using logotherapeutic analysis to explore the ideological and social factors that give rise to these disturbances. Among these postmodern neuroses, we find algophobia as a generalized fear of human suffering, emotional hypochondria as the neurosis of constant happiness, narcissistic depression as the despondency of the performance subject, noogenic neurosis as the existential frustration of the era, and mass nihilism as emptiness and loss of hope in life. These neuroses provoke an existential crisis among postmodern social masses, which logotherapy views as a progressive loss of the values of self-realization and meaning.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 2","pages":"e3173"},"PeriodicalIF":0.8,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147521400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the cultural adaptation of the \"Long Coronavirus Disease (COVID) Symptom and Impact Tools\" for the Chilean population.","authors":"Vivienne C Bachelet, Rosa Jiménez-Paneque, Patricio Gomolán, Ignacio Silva-Ayarza, Mercedes López Nitsche, Catalina O Andrades, Belén Carroza, Bruno Morgado","doi":"10.5867/medwave.2026.02.3205","DOIUrl":"https://doi.org/10.5867/medwave.2026.02.3205","url":null,"abstract":"<p><strong>Introduction: </strong>The Long Coronavirus Disease (COVID) Symptom and Impact Tools (ST and IT) are self-administered instruments designed to monitor symptoms and the impact of long COVID. We translated and culturally adapted these tools for use in Chile. This study evaluated internal consistency and test-retest reliability for the IT, described reported symptoms with the ST, and explored changes over time.</p><p><strong>Methods: </strong>The first phase, previously published, involved translation and cultural adaptation. The second phase included 28 patients with persistent COVID-19 symptoms; 20 completed a second assessment. The IT assesses impact using six items, each scored 0-10 (total 0-60). The ST lists 53 symptoms across ten categories. Internal consistency of the IT was assessed using Cronbach's alpha and item-consistency indicators. Test-retest reliability was evaluated using the intraclass correlation coefficient (ICC, 95% CI) and a Bland-Altman analysis. ST responses were summarized with absolute and relative frequencies and confidence intervals.</p><p><strong>Results: </strong>The IT showed excellent internal consistency (Cronbach's alpha 0.945; 95% CI 0.906-0.971). Test-retest reliability was acceptable (ICC 0.72; 95% CI 0.43-0.88), with minimal bias in the Bland-Altman plot. General, neurological, thoracic, and ear-nose-throat symptoms were the most frequent. Participants reported a mean of 19 symptoms, with no significant differences between visits.</p><p><strong>Conclusions: </strong>The adapted tools demonstrated acceptable psychometric properties and appear suitable for use in Chile. Symptom reporting was extensive, underscoring the need for larger studies to confirm these findings.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 2","pages":"e3205"},"PeriodicalIF":0.8,"publicationDate":"2026-03-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458506","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"General aspects of rehabilitation in Guillain-Barre syndrome: A literature review.","authors":"Jaime Vallejos G, Cristóbal Jeldres C, Vicente Abarza de la P, José Miguel Muñoz R","doi":"10.5867/medwave.2026.02.3143","DOIUrl":"https://doi.org/10.5867/medwave.2026.02.3143","url":null,"abstract":"<p><strong>Introduction: </strong>Guillain-Barré syndrome is the most common cause of acquired flaccid paralysis worldwide. Although care traditionally focuses on overcoming the acute phase, many patients continue to experience residual symptoms such as weakness, neuropathic pain, autonomic dysfunction, and fatigue. These sequelae can result in significant disability and adversely affect long-term functionality and quality of life, underscoring the importance of an early, coordinated, and multidisciplinary treatment approach.</p><p><strong>Methods: </strong>A non-systematic narrative review of the literature on functional recovery in adults with Guillain-Barré syndrome was conducted. The review included narrative and systematic review articles, original research studies, clinical practice guidelines, and expert consensus statements. The search strategy prioritized rehabilitation protocols, prognostic predictors, and interventions targeting motor, sensory, autonomic, and psychosocial domains. Articles were retrieved from PubMed, Embase, and PEDro databases, with preference given to publications from 2015 to 2025, in both English and Spanish.</p><p><strong>Results: </strong>Evidence supports the implementation of a structured rehabilitation program tailored to the patient's clinical stage, prognostic factors, and functional goals. Interventions include motor re-education, respiratory muscle training, orthotic prescription, neuropathic pain management, and symptomatic treatment of fatigue and autonomic disturbances, all while considering the individual's personal and social context. Prognostic tools such as the Modified Erasmus Guillain-Barré Syndrome Outcome Score and the Medical Research Council sum score are useful for designing the rehabilitation plan.</p><p><strong>Conclusion: </strong>The long-term sequelae of Guillain-Barré syndrome highlight the need for a comprehensive rehabilitation approach that encompasses physical, cognitive, and psychosocial domains. Early multidisciplinary interventions and continuity of care should be the therapeutic focus. Some rehabilitation interventions still require more evidence for their implementation in practice.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 2","pages":"e3143"},"PeriodicalIF":0.8,"publicationDate":"2026-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147458412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Toward an embodied pedagogy of care in specialist training in Chile: radical care and humanization in public health.","authors":"Kristopher Gómez","doi":"10.5867/medwave.2026.02.3180","DOIUrl":"https://doi.org/10.5867/medwave.2026.02.3180","url":null,"abstract":"<p><p>The training of health specialists is a strategic component for the operational, human, and territorial sustainability of the public health system. However, Chilean university training models-primarily oriented toward technical efficiency-have tended to marginalize the relational and ethical dimensions of care, weakening the experience of care and diminishing trust in health institutions. From a theoretical-reflective perspective, this article explores the possibilities and tensions that arise when transferring the principles of radical care and their performative version, Embodying Radical Care to the field of specialist medical training in Chile, proposing that these approaches may contribute to reconfiguring medical training processes toward an embodied ethics of care. From this perspective, the article develops a comparative analysis of theoretical approaches that integrates care ethics, the politics of interdependence, and performative practice. Incorporating these perspectives could strengthen relational and affective competencies in clinical teaching, deepening the learning process through the ethics of radical care and recognizing bodily experience and ethical sensitivity as dimensions of professional formation. At the same time, these principles could improve the experience of care by fostering a culture that acknowledges interdependence among people, institutions, and territories, thereby consolidating a more humane and sustainable medical practice. Ultimately, this reflection seeks to offer conceptual foundations for public policies on training and humanization in health that understand care not merely as a technical act, but as an ethical, political, and aesthetic practice essential for the sustainability of the health system.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 2","pages":"e3180"},"PeriodicalIF":0.8,"publicationDate":"2026-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147434225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Telehealth cochlear implant programming in Chile yields outcomes comparable to in-person clinical care.","authors":"Javiera Herrada Andreoli, Paul H Delano, Ana Maria Morris, Rocio Carvajal Diaz, Ana Claudia Martinho-Carvalho, Smita Agrawal","doi":"10.5867/medwave.2026.01.3164","DOIUrl":"10.5867/medwave.2026.01.3164","url":null,"abstract":"<p><strong>Introduction: </strong>Remote programming can improve access and help overcome barriers related to distance, cost, and travel in the follow-up care of cochlear implant users. This study evaluates the ease of use, effectiveness, and acceptability of the remote programming system for cochlear implant users.</p><p><strong>Methods: </strong>Cross-sectional study with 14 adult participants. The first phase included in-person and remote programming sessions at the hospital, while the second focused on remote programming sessions in participants' homes. In each phase, speech perception with the created programs was evaluated in a soundproof booth. Subjective feedback was obtained from audiologists and users through customized questionnaires.</p><p><strong>Results: </strong>Speech scores indicated that both maps created remotely at the hospital (first phase of the study) and those created at home (second phase of the study) provided comprehension of phrases and words that was not inferior to that of the map created in person. Scores for disyllabic words with audiovisual cues, obtained through remote programming at home, were not inferior to those obtained through remote programming at the hospital. In the subjective evaluation, both participants and audiologists indicated that the experience with remote programming was satisfactory.</p><p><strong>Conclusions: </strong>Remote programming was found to be as effective as in-person programming, as it provided access to the programming parameters and objective measures used in in-person sessions. Speech recognition results were similar for programs created in person and remotely. Participants indicated that the remote programming method and the resulting program were useful and acceptable, and that they experienced similar ease and quality of communication.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 1","pages":"e3164"},"PeriodicalIF":0.8,"publicationDate":"2026-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147317903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}