Medwave最新文献

{"title":"Efficacy and safety of goserelin vs. leuprolide in premenopausal breast cancer patients receiving adjuvant endocrine therapy: A retrospective cohort study.","authors":"Jiahao Xu, Yicheng Tai, Qi Fang, Hui Xue, Nan Hu","doi":"10.5867/medwave.2026.07.3216","DOIUrl":"https://doi.org/10.5867/medwave.2026.07.3216","url":null,"abstract":"<p><strong>Introduction: </strong>Goserelin and leuprolide are gonadotropin-releasing hormone (GnRH) agonists used for ovarian function suppression in premenopausal breast cancer patients. Whether their different molecular structures lead to clinically meaningful differences in efficacy and safety remains unclear.</p><p><strong>Objectives: </strong>To compare the efficacy and safety of goserelin versus leuprolide as adjuvant endocrine therapy (combined with tamoxifen) in premenopausal women with hormone receptor-positive breast cancer after curative surgery.</p><p><strong>Methods: </strong>This retrospective cohort study initially recruited 215 young cancer patients receiving adjuvant chemotherapy with tamoxifen combined with a gonadotropin-releasing hormone agonist. After applying inclusion and exclusion criteria, 187 patients were included and divided into two groups according to the gonadotropin-releasing hormone agonist they actually received: leuprolide (n=90) or goserelin (n=97). The primary efficacy outcome was the proportion of patients achieving substantial estrogen reduction (estradiol ≤30 pg/mL or falling into the pre-specified laboratory range) after 6 months. Secondary outcomes included liver function parameters and thyroid function parameters. Exploratory outcomes included changes from baseline to six months in testosterone, luteinizing hormone (LH), follicle-stimulating hormone (FSH), and prolactin levels, as well as descriptive assessment of the tumor marker carcinoembryonic antigen (CEA). Between-group differences were expressed as risk differences (RDs) with 95% confidence intervals (CIs).</p><p><strong>Results: </strong>Baseline demographic and cancer-related characteristics were balanced between the two groups. After six months of adjuvant therapy, the two groups showed similar primary efficacy: the proportion of patients with substantial estrogen reduction was 88.89% in the leuprolide group and 92.78% in the goserelin group (RD = -3.89%, 95% CI: -12.18% to 4.40%; p = 0.354). Regarding safety, the leuprolide group had a significantly higher rate of liver function abnormalities (30.00% vs. 13.40%; RD = 16.60%, 95% CI: 4.96% to 28.24%; p = 0.012), driven mainly by a lower rate of normal aspartate aminotransferase (AST) levels (85.56% vs. 96.91%; RD = -11.35%, 95% CI: -19.39% to -3.31%; p < 0.05). In contrast, the leuprolide group had a higher rate of normal thyroid function (88.89% vs. 76.29%; RD = 12.60%, 95% CI: 1.94% to 23.26%; p = 0.018), mainly due to a higher normal thyroid-stimulating hormone rate (93.33% vs. 83.51%; RD = 9.82%, 95% CI: 0.82% to 18.82%; p < 0.05). Carcinoembryonic antigen normalization rates were also comparable (93.33% vs. 92.78%; RD = 0.55%, 95% CI: -6.74% to 7.84%; p = 0.549).</p><p><strong>Conclusions: </strong>Leuprolide and goserelin demonstrate similar efficacy when used as adjuvant therapy in combination with tamoxifen for young women with breast cancer. However, leuprolide may pose a potential ri","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 7","pages":"e3216"},"PeriodicalIF":0.8,"publicationDate":"2026-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795278","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":"Nuevas perspectivas en la cardiopatía chagásica: genética, resonancia magnética y posibles alternativas terapéuticas. Una revisión narrativa.","authors":"Maria-Teresa Urrutia","doi":"10.5867/medwave.2026.07.3245","DOIUrl":"10.5867/medwave.2026.07.3245","url":null,"abstract":"","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 7","pages":"e3245"},"PeriodicalIF":0.8,"publicationDate":"2026-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148726594","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":"New perspectives on chagasic cardiomyopathy: A narrative review of genetics, magnetic resonance imaging and therapeutic alternatives.","authors":"Jose Martin Velasco Hurtado, Dayannara Quispe Zavala, Chiara Vilela Luchini, Renzo Reineiro Rosales Gutiérrez","doi":"10.5867/medwave.2026.07.3236","DOIUrl":"10.5867/medwave.2026.07.3236","url":null,"abstract":"<p><p>Chagasic cardiomyopathy is the chronic manifestation of American trypanosomiasis. In endemic regions of Peru, delayed diagnosis remains a major public health concern. This review analyzes recent evidence (2020 to 2026) regarding the impact of genetic variants on severity, the utility of cardiac magnetic resonance imaging, and the efficacy of trypanocidal and advanced support treatment. A search was conducted in PubMed and Scopus, prioritizing clinical trials and meta-analyses. Current data challenge the direct relationship between parasite lineage and cardiac severity, highlighting the host inflammatory response as the primary driver. Diagnostically, cardiac magnetic resonance imaging surpassed echocardiography in identifying early fibrosis and defining arrhythmic risk. Regarding therapy, benznidazole use during the indeterminate phase reduced the risk of clinical progression (Relative Risk (RR) 0.35), challenging traditional palliative approaches. In conclusion, current evidence repositions etiological treatment as a viable preventive strategy and underscores the importance of cardiac magnetic resonance imaging for early clinical management.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 7","pages":"e3236"},"PeriodicalIF":0.8,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706721","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":"Diagnostic accuracy of the FINDRISC questionnaire for detecting type 2 diabetes mellitus in an indigenous population from Northeastern Sierra of Puebla, Mexico.","authors":"Maylin Almonte-Becerril, América Martínez-Calleja, Nancy Marbella Parra-Torres, Geu Mendoza-Catalán","doi":"10.5867/medwave.2026.07.3195","DOIUrl":"https://doi.org/10.5867/medwave.2026.07.3195","url":null,"abstract":"<p><strong>Introduction: </strong>The Finnish Diabetes Risk Score questionnaire is a widely used tool for screening type 2 diabetes mellitus; however, its application in Indigenous populations has been little studied. This study assessed the diagnostic accuracy of this questionnaire for detecting cases consistent with type 2 diabetes mellitus in the Totonac population of the state of Puebla, Mexico, and its performance when stratified by gender.</p><p><strong>Methods: </strong>A cross-sectional diagnostic accuracy study with prospective data collection was conducted in 148 adults (≥18 years) without a previous diagnosis of type 2 diabetes mellitus. Participants were residents of communities in the Sierra Nororiental of Puebla and were recruited through convenience sampling with consecutive enrollment during a health fair. The Finnish Diabetes Risk Score questionnaire was used as the index test, evaluated using two cutoff points (≥12 and ≥15); glycated hemoglobin (≥6.5%) was used as the reference standard. Both tests were administered independently and with assessor blinding. Sensitivity, specificity, predictive values, diagnostic accuracy, and the area under the curve were estimated through overall and gender-stratified analyses.</p><p><strong>Results: </strong>At the ≥12 cut-off point, the Finnish Diabetes Risk Score showed an overall sensitivity of 76.4% (95%; CI: 66.6 to 84.0), specificity of 55.9% (95%; CI: 43.3 to 67.9), diagnostic accuracy of 68.2% (95%; CI: 60.4 to 75.2), and an area under the curve of 0.64 (95%; CI: 0.54 to 0.73). In women, sensitivity reached 85.2% (95%; CI: 73.4 to 92.3) and the area under the curve was 0.71 (95%; CI: 0.60 to 0.81), whereas in men the discriminative capacity was limited.</p><p><strong>Conclusions: </strong>The Finnish Diabetes Risk Score questionnaire demonstrated moderate discriminative capacity for detecting cases compatible with type 2 diabetes mellitus in the Totonac Indigenous population, with acceptable performance in women using the cut-off point of ≥12. These findings support its use as an initial screening tool in settings with limited access to confirmatory tests and highlight the need for validation in specific contexts.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 7","pages":"e3195"},"PeriodicalIF":0.8,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670121","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":"Effectiveness and safety of acetazolamide plus loop diuretics in acute congestive heart failure: A living systematic review - Version 2026 1.0.","authors":"Franco Schettino-Orellana, Felipe Vega González, Iván Godoy Cofré, Florencia Honorato Labarca, Rodrigo Sepúlveda Palamara, Macarena Morel-Marambio, Luis Ortiz-Muñoz","doi":"10.5867/medwave.2026.06.3217","DOIUrl":"10.5867/medwave.2026.06.3217","url":null,"abstract":"<p><strong>Objective: </strong>This living systematic review Version 1.0 aims to provide a timely, rigorous and continuously updated summary of the evidence on the use of acetazolamide plus loop diuretics in acute congestive heart failure compared to loop diuretics.</p><p><strong>Methods: </strong>We conducted a comprehensive search in CENTRAL, EMBASE, MEDLINE, and between database inception and September 2025. No language, publication date or status restrictions were applied. Two reviewers independently screened eligible studies, according to predefined selection criteria, and extracted data using a predesigned form. We performed meta-analyses using random-effects models and assessed overall certainty in evidence using the GRADE approach. The quality of the evidence was assessed using the Cochrane risk-of-bias tool. This review was registered in PROSPERO (CRD42024575267).</p><p><strong>Results: </strong>Of 732 records identified, five randomized trials were included, with a total of 1050 participants. The evidence is very uncertain about the effect of adding acetazolamide to loop diuretics in decongestion observed at 72 hours (risk ratio: 1.17, 95% confidence interval: 0.96 to 1.44). Low certainty evidence shows adding acetazolamide to loop diuretics may increase natriuresis at 24 hours (mean difference 38.43, 95% confidence interval: 19.42 to 57.43). No significant differences were found between groups in accumulative diuresis at 48 hours, all-cause mortality, readmission due to heart failure or worsening renal function.</p><p><strong>Conclusions: </strong>Evidence suggests that it is necessary to promote further investigations regarding the use of acetazolamide plus loop diuretics in acute congestive heart failure. More robust, standardized, long-term studies are needed, and conclusions may change as new data emerge.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 6","pages":"e3217"},"PeriodicalIF":0.8,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148631058","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":"Depression stigma in Chile: A qualitative study of beliefs, emotions, and behaviors toward people with depression.","authors":"Natalia Salinas-Oñate, María José Segú-Flores, Camila Salazar-Fernández, Tatiana Alarcón-Jouanet, Rubén Alvarado Muñoz","doi":"10.5867/medwave.2026.06.3227","DOIUrl":"https://doi.org/10.5867/medwave.2026.06.3227","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;Depression is one of the leading causes of disability in Chile and significantly affects adults' well-being and social participation. Despite its high prevalence, depression stigma has been scarcely studied in the country. Because its manifestations vary across sociocultural contexts, understanding how it is configured in Chile is essential for developing contextually relevant interventions. Within this framework, depression stigma is examined through its core components -stereotypes, prejudice, and discrimination- by analyzing the beliefs, emotions, and behaviors directed toward people living with depression The aim of this study is to explore, from the perspective of Chilean adults, the socially shared beliefs about people living with depression, as well as the emotions and behaviors directed toward them, and to examine the extent to which these contents are understood as expressions of depression stigma.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A qualitative study was conducted using purposive sampling and minimum group representativeness criteria based on gender, socioeconomic status, and history of depression. Sixty-six adults from three regions of Chile took part in individual semi-structured interviews. Interviews were transcribed, reviewed, returned to participants for checking, and coded by two independent coders. Data were then analyzed using a deductive-inductive content analysis approach supported by Atlas.ti, and findings were triangulated.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Findings were organized into three analytical macro-categories - beliefs, emotions, and behaviors directed toward people with depression - consistent with the cognitive, affective, and behavioral components of stigma described in the literature. Within beliefs, contents related to affective characteristics, behavioral characteristics, and dispositional attributions associated with people with depression emerged. Within emotions, compassionate emotions, defensive and discomfort-related responses, and affective disconnection were identified. Within behaviors, overprotection, social distancing, invalidation and judgment emerged, along with interaction scripts based on avoidance or support.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Depression stigma in Chile is configured through contents that, to varying degrees, are understood as stereotypes, prejudice, and discrimination. Beliefs combine elements linked both to mental health literacy and to stereotypes; emotions are primarily interpreted as expressions of prejudice; and behaviors reflect both subtle and overt forms of discrimination. Additionally, some themes showed divergent interpretations among participants, particularly between those with and without a history of depression. Taken together, these findings contribute to a better understanding of how this phenomenon is structured in the Chilean context and provide input for the development of culturally relevant assessment instruments and interve","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 6","pages":"e3227"},"PeriodicalIF":0.8,"publicationDate":"2026-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620440","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":"Clinical and epidemiological characteristics of intensive care unit-acquired weakness in Latin America: A scoping review protocol.","authors":"Rocío Fuentes-Aspe, Jasim Najum-Flores, Felipe González-Seguel, Ruvistay Gutiérrez-Arias, Francisca María Contreras-Flores, Pamela Seron","doi":"10.5867/medwave.2026.06.3213","DOIUrl":"10.5867/medwave.2026.06.3213","url":null,"abstract":"<p><strong>Introduction: </strong>Intensive care unit-acquired weakness is a condition with a substantial impact on morbidity, mortality, and long-term quality of life. Consolidated evidence on this condition in Latin America remains limited. This gap may be influenced by regional differences in healthcare systems, resource availability, and population characteristics, which restrict a comprehensive understanding of the condition in this context.</p><p><strong>Objectives: </strong>This scoping review aims to describe and map the evidence on the clinical and epidemiological characteristics of adults hospitalized in intensive care units in Latin America with intensive care unit-acquired weakness.</p><p><strong>Methods: </strong>This review will follow the Joanna Briggs Institute methodological framework and will be reported in accordance with the PRISMA guidelines. A search strategy will be applied across the main databases and regional repositories. Studies involving adults hospitalized in intensive care units in Latin American countries that address intensive care unit-acquired weakness will be included. Study selection and data extraction will be conducted independently by two reviewers. Extracted data will include study characteristics, demographic and clinical variables, diagnostic approaches, risk factors, and reported strategies for prevention or management.</p><p><strong>Expected results: </strong>This review is expected to provide a comprehensive description of intensive care unit-acquired weakness in Latin America, highlighting reported clinical and epidemiological patterns, methodological heterogeneity, and both geographic and thematic knowledge gaps. The findings will help design context-specific strategies for evaluation, prevention, and rehabilitation, contributing to strengthen future research within the region.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 6","pages":"e3213"},"PeriodicalIF":0.8,"publicationDate":"2026-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148605193","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":"Fear of cancer recurrence and quality of life in early breast cancer survivors: association with clinical and sociodemographic characteristics.","authors":"Natalia Camejo, Cecilia Castillo, Dahiana Amarillo, Virginia Suaya, Maria Guerrina, Gianina Muñoz, Lujan Cabrera, Lucia Argenzio, Rosina Servetto, Guadalupe Herrera, Joselina Ibarburu, Gabriel Krygier","doi":"10.5867/medwave.2026.06.3200","DOIUrl":"10.5867/medwave.2026.06.3200","url":null,"abstract":"<p><strong>Introduction: </strong>Fear of cancer recurrence is one of the most frequent concerns among breast cancer survivors and can significantly affect health-related quality of life. However, it remains insufficiently explored in routine clinical practice. The aim of this study is to describe the frequency of fear of cancer recurrence and quality of life in patients with early breast cancer, to analyze their association with clinical and sociodemographic characteristics. As a complementary descriptive exploration, communication between patients and the healthcare team regarding fear of cancer recurrence was also assessed.</p><p><strong>Methods: </strong>Cross-sectional observational study conducted in two public centers. A total of 301 women with stage I-III breast cancer, disease-free and at least 12 months post-treatment, were included. Fear of cancer recurrence was assessed using the Cancer Worry Scale, and quality of life was evaluated using the PROMIS Global 10 questionnaire.</p><p><strong>Results: </strong>High fear of cancer recurrence was observed in 34.9% of participants, and moderate fear of cancer recurrence in 20.9%. This concern was significantly associated with ≤5 years since diagnosis, age <50 years, education level, chemotherapy, and endocrine therapy. No associations were found with tumor stage, type of breast surgery, axillary surgery, or radiotherapy. Nearly half of the patients had not discussed fear of cancer recurrence with their medical team, mainly because they did not consider it a serious issue or were unaware that it could be addressed during consultations. PROMIS scores showed median values of 37.4 for physical health and 43.5 for mental health. Quality of life did not vary according to clinical characteristics or treatments but was associated with age and education. Patients with higher fear of cancer recurrence consistently showed poorer quality of life across all domains (p < 0.001).</p><p><strong>Conclusions: </strong>Fear of cancer recurrence is highly frequent and strongly associated with poorer quality of life, independently of clinical variables. Its identification and management should be systematically integrated into survivorship care for women with breast cancer.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 6","pages":"e3200"},"PeriodicalIF":0.8,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148437191","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":"Exploratory study to identify facilitators and barriers for implementing a multiplatform communication app for prehospital screening and transfer follow-up in acute stroke.","authors":"Francisca Gonzalez McCawley, Paula Munoz-Venturelli, Victor Navia González, Claudia Chamorro Sandoval, Francisca Urrutia Goldsack, Alejandra Del Río, Andrés Silva, José Vallejos","doi":"10.5867/medwave.2026.05.3196","DOIUrl":"https://doi.org/10.5867/medwave.2026.05.3196","url":null,"abstract":"<p><strong>Introduction: </strong>Early-stage stroke management is a complex, time-sensitive healthcare process requiring coordinated action and prompt decision-making. JOIN is a multiplatform communication application that streamlines and facilitates healthcare coordination. The objective of the study was to explore the process of implementing and using JOIN across a network of hospitals within the South-East Metropolitan Health Service to identify facilitators, barriers, and perceptions of its impact.</p><p><strong>Methods: </strong>A multiple-case study design was conducted based on a qualitative research framework. The process evaluation used purposive sampling to capture relevant experiences across diverse hospital contexts. Semi-structured interviews were conducted with individuals involved in implementing and using JOIN. Coding was performed using ATLAS.ti software, based on thematic analysis and an iterative procedure. The analysis was based on the components of process normalization theory and focused on evaluating key implementation outcomes.</p><p><strong>Results: </strong>During the interviews (n = 8), some of the facilitators identified ongoing training and the presence of a leader as factors in the use of JOIN. Overload of the emergency care system, resistance to change, and difficulties with technology use were among the barriers identified. Although the application's benefits (user-friendly and intuitive) were recognized, the implementation process posed significant challenges. Fidelity and feasibility were the most difficult implementation outcomes to achieve.</p><p><strong>Conclusions: </strong>The process evaluation highlights the importance of ongoing training and leadership for implementing new interventions within emergency healthcare settings. Furthermore, it emphasized the importance of achieving a comprehensive understanding of the context to improve implementation.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 5","pages":"e3196"},"PeriodicalIF":0.8,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148318187","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":"Mechanistic analysis of COVID-19 cases in Chile during the second half of 2020: an SIR model with dynamic transmission rate.","authors":"Fernando Córdova Lepe, Ranghely Hernández Castañeda, Rodrigo Gutiérrez, Juan Pablo Gutiérrez Jara","doi":"10.5867/medwave.2026.05.3191","DOIUrl":"10.5867/medwave.2026.05.3191","url":null,"abstract":"<p><strong>Introduction: </strong>This article analyzes the prolonged trough phase in the epidemic curve associated with COVID-19 dynamics in Chile during the period July-December 2020, characterized by a relatively stable daily record of 1 000-2500 cases.</p><p><strong>Methods: </strong>Unlike traditional (, )-SIR models, with constant parameters and associated respectively with the transmission and removal rates in the infectious process, which predict unimodal behavior, we propose an approach based on Contagion Mechanics that incorporates a dynamic law for the transmission rate .</p><p><strong>Results: </strong>Using official data from the Department of Health Statistics and Information, we demonstrate how this approach quantitatively captures the observed stabilization, resulting from sustained adherence to non-pharmaceutical measures by the Chilean population. The model reveals that maintaining the infection rate below its intrinsic value required sustained collective effort, enabling controlled management of hospital demand during the pre-vaccination stage.</p><p><strong>Conclusions: </strong>Our results validate the usefulness of Contagion Mechanics in explaining complex epidemiological dynamics and offer new perspectives on the population response to prolonged health interventions.</p>","PeriodicalId":18597,"journal":{"name":"Medwave","volume":"26 5","pages":"e3191"},"PeriodicalIF":0.8,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148302394","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}