Archives of Medical Research最新文献_第3页

Bypassing sources of care by level and coverage: Access to essential services in Peru and Uruguay in the post-pandemic era 按级别和覆盖范围划分的绕过医疗来源：后流行病时代秘鲁和乌拉圭的基本服务获取情况。

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-10-05 DOI: 10.1016/j.arcmed.2024.103087

{"title":"Bypassing sources of care by level and coverage: Access to essential services in Peru and Uruguay in the post-pandemic era","authors":"","doi":"10.1016/j.arcmed.2024.103087","DOIUrl":"10.1016/j.arcmed.2024.103087","url":null,"abstract":"<div><h3>Background and aims</h3><div>Healthcare provision to distinct social groups in Latin America contributes to inequities. Individuals make active choices by bypassing their coverage and intended healthcare source. After the pandemic, we sought to characterize bypassing behaviors and quantify their effects on access to essential services.</div></div><div><h3>Methods</h3><div>Cross-sectional data from a population-based telephone survey in Peru and Uruguay were analyzed. Participants were selected by random digit dialing. Outcomes were defined as access to preventive screenings and satisfaction of emerging health needs. Bypassing by level was defined as when participants went around primary care for the usual source of care or last preventive visit; bypassing by coverage when care was sought outside of public coverage or social security. Sociodemographic characteristics were included, and the adjusted average treatment effect was calculated.</div></div><div><h3>Results</h3><div>Data from 1,255 participants in Peru and 1,237 participants in Uruguay were analyzed. Bypassing behaviors by level (32% Peru; 60% Uruguay) and coverage (29% Peru; 21% Uruguay) were more prevalent in more privileged groups, especially in Peru. System competence was low overall and varied by bypassing mode, especially in Peru. In the adjusted analysis, statistically significant differences were found in bypassing by coverage in Peru (–8% difference in unmet health needs) and by level in Uruguay (5% more unmet needs).</div></div><div><h3>Conclusion</h3><div>Provision of essential preventive services was insufficient in both countries. In Peru, bypassing could serve as a proxy measure of inequities. Reminders of preventive services could be offered to bypassers of primary care. Profound health system reforms are needed to ensure equitable access to essential services.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382740","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetics in reproductive medicine 生殖医学遗传学。

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-09-28 DOI: 10.1016/j.arcmed.2024.103092

引用次数: 0

Response to: Serendipitous adrenal hyperplasia in patients admitted to the emergency department is linked to increased mortality 回应：急诊科入院患者偶然出现的肾上腺增生与死亡率增加有关。

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-09-28 DOI: 10.1016/j.arcmed.2024.103089

引用次数: 0

Evaluation of TALK© training for interprofessional clinical debriefing in Latin America 对拉丁美洲跨专业临床汇报 TALK© 培训的评估

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-09-26 DOI: 10.1016/j.arcmed.2024.103060

{"title":"Evaluation of TALK© training for interprofessional clinical debriefing in Latin America","authors":"","doi":"10.1016/j.arcmed.2024.103060","DOIUrl":"10.1016/j.arcmed.2024.103060","url":null,"abstract":"<div><h3>Background</h3><div>Healthcare systems must adapt iteratively in response to external and local challenges while keeping patients and staff safe. Clinical debriefing is a cost-effective contributor to safety culture, facilitating learning and team adaptations that lead to improved processes, patient outcomes, and staff resilience. In the aftermath of the COVID-19 pandemic, an interest has emerged in adopting TALK© to guide clinical debriefing to promote safety, mutual support, and cultural change within healthcare teams in Latin American contexts.</div></div><div><h3>Aims</h3><div>To evaluate the quality and applicability of TALK© debriefing training in Latin American settings and the willingness to debrief after an educational intervention.</div></div><div><h3>Methods</h3><div>Retrospective and descriptive study, examining anonymous data collected over 18 months after completing a “TALK© Debriefing Course for Healthcare Professionals” face-to-face or online. Data collected included participant characteristics, course details, quality and applicability of the intervention, and willingness to debrief.</div></div><div><h3>Results</h3><div>Five hundred and forty-five participants were enrolled, most from Argentina and Mexico. The overall quality of the intervention scored 19.62/20 points, obtaining 4.86/5 points for applicability. There were no significant differences between virtual and face-to-face sessions.</div><div>After the intervention, ≥93.76% of participants felt able to engage in clinical debriefing, and 97.06% reported willingness to debrief.</div></div><div><h3>Conclusions</h3><div>Dissemination of multi-professional clinical debriefing training in Latin America is feasible and easily scalable. The quality of the educational intervention was rated excellent in both virtual and face-to-face settings, supporting the value of remote educational diffusion. Most participants in this study intervention felt prepared and willing to debrief following the intervention.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142323088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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New Drugs and Promising Drug Combinations in the Treatment of Chagas Disease in Brazil: A Systematic Review and Meta-Analysis 治疗巴西南美锥虫病的新药和有前途的药物组合：系统回顾与元分析

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-09-26 DOI: 10.1016/j.arcmed.2024.103084

{"title":"New Drugs and Promising Drug Combinations in the Treatment of Chagas Disease in Brazil: A Systematic Review and Meta-Analysis","authors":"","doi":"10.1016/j.arcmed.2024.103084","DOIUrl":"10.1016/j.arcmed.2024.103084","url":null,"abstract":"<div><div>Chagas disease (CD) is a parasitic infection caused by the protozoan <em>Trypanosoma cruzi</em> (Kinetoplastida, Trypanosomatidae). Benznidazole (Bz) has a limited ability to interfere with the pathogenicity of the parasite, which manages to overcome host defenses. This study aimed to conduct a systematic literature review and meta-analysis to understand and describe the drugs and their combinations, as well as new promising compounds used in the treatment of CD in Brazil. This study was registered in the Open Science Framework (OSF) and the International Prospective Register of Systematic Reviews, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Searches were performed in the electronic scientific databases PubMed, LILACS, SciELO, and BVS. Searches were conducted using descriptors cataloged in the Health Sciences Descriptors (DeCS) and Medical Subject Headings (MeSH), in Portuguese, English, and Spanish. Of the 26 articles included in this systematic review and meta-analysis, 16 were related to drug combinations, and nine described new inhibitors of parasitic molecules. Despite high heterogeneity (<em>I</em>² = 92%), studies that evaluated the combination of Bz with other treatments for CD had an overall grouped cure rate of 74% (95% CI 54–94%). Only one study presented drug repositioning by monotherapy. Thus, drug combinations offer quick and accessible solutions for CD treatment, acting against resistant strains of <em>T. cruzi</em>. Certainly, the introduction of these promising compounds into the pharmaceutical market is distant, and the adoption of prophylactic measures is recommended as a barrier to the increasing number of CD cases.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142322591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transcranial Direct Current Stimulation for Cognitive Impairment Rehabilitation: A Bibliometric Analysis 经颅直流电刺激用于认知障碍康复：文献计量分析

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-09-25 DOI: 10.1016/j.arcmed.2024.103086

{"title":"Transcranial Direct Current Stimulation for Cognitive Impairment Rehabilitation: A Bibliometric Analysis","authors":"","doi":"10.1016/j.arcmed.2024.103086","DOIUrl":"10.1016/j.arcmed.2024.103086","url":null,"abstract":"<div><h3>Background and aims</h3><div>As global demographics shift toward an older population, cognitive impairment is becoming increasingly critical. Transcranial Direct Current Stimulation (tDCS), an innovative brain stimulation technique, has the potential to significantly improve cognitive function. Our main aim is to comprehensively analyze the existing literature, identify key aspects of tDCS research in the rehabilitation of cognitive impairment, and predict future trends in this field.</div></div><div><h3>Methods</h3><div>We used the Web of Science (WOS) database to search for English articles and reviews relevant to this topic. For visual analysis of the literature, we employed the WOS analysis tool, CiteSpace, along with VOSviewer software to ensure comprehensive analysis.</div></div><div><h3>Results</h3><div>We included 2940 articles published between 1998 and 2023. Over 25 years, annual publications and citations in this field increased steadily, peaking at 379 articles in 2021. Michael A. Nitsche was a major contributor. Most articles came from developed countries, primarily North America and Europe, and journals generally had modest impact factors. Research in this field primarily aims to treat cognitive impairment resulting from pathological aging or neuropsychiatric disorders, with a particular focus on specific brain regions. Recently, researchers have integrated various treatment modalities with tDCS techniques to actively investigate effective strategies to mitigate cognitive impairments associated with pathological aging.</div></div><div><h3>Conclusion</h3><div>This study presents the first bibliometric analysis of the literature on tDCS in the rehabilitation of cognitive impairment, highlighting key areas of research and emerging trends. These findings provide critical insights for future tDCS interventions targeting cognitive impairment associated with pathological aging.</div></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142318710","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Preliminary efficacy and safety analysis of tafamidis in post-liver transplant patients with hereditary transthyretin cardiac amyloidosis 他法米迪对肝移植后遗传性转甲状腺素心脏淀粉样变性患者的初步疗效和安全性分析

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-09-17 DOI: 10.1016/j.arcmed.2024.103083

{"title":"Preliminary efficacy and safety analysis of tafamidis in post-liver transplant patients with hereditary transthyretin cardiac amyloidosis","authors":"","doi":"10.1016/j.arcmed.2024.103083","DOIUrl":"10.1016/j.arcmed.2024.103083","url":null,"abstract":"<div><p>Hereditary transthyretin cardiac amyloidosis (ATTRv-CA) after liver transplantation remains challenging to treat due to residual amyloid deposits in extrahepatic organs, including the heart. Tafamidis, a transthyretin tetramer stabilizer, has shown promise in the treatment of ATTRv-CA; however, its efficacy and safety after liver transplantation are uncertain. In this preliminary retrospective review, we assessed the efficacy and safety of tafamidis (80 mg) in three ATTRv-CA cases after liver transplantation. Following one year of treatment, all patients experienced improvement in dyspnea, New York Heart Association functional class, brain natriuretic peptide levels, and cardiac troponin T levels. No significant changes in echocardiographic parameters were observed. Notably, no cardiovascular or drug-related adverse events occurred during treatment. Our findings suggest that tafamidis may benefit post-liver transplant patients with ATTRv-CA and warrant further investigation through randomized controlled trials with larger cohorts. This study highlights a potential therapeutic avenue for the management of cardiovascular involvement in this challenging patient population.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142238775","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Convergences and Divergences in the Burden of Disease in Older People Across The Organisation for Economic Cooperation and Development Countries 经济合作与发展组织各国老年人疾病负担的趋同与差异

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-09-15 DOI: 10.1016/j.arcmed.2024.103082

{"title":"Convergences and Divergences in the Burden of Disease in Older People Across The Organisation for Economic Cooperation and Development Countries","authors":"","doi":"10.1016/j.arcmed.2024.103082","DOIUrl":"10.1016/j.arcmed.2024.103082","url":null,"abstract":"<div><h3>Background</h3><p>The Organization for Economic Cooperation and Development (OECD) member states are heterogeneous in their social, economic, and health conditions.</p></div><div><h3>Aims</h3><p>a) to analyze age-specific mortality rate (ASMR) and age-specific disability-adjusted life year (DALY) rate among older people in countries by age groups (65–74 years and 75+ years) and sex, and b) to estimate the association between age-specific DALY rate with Socio-Demographic Index (SDI) and with Healthcare Access and Quality Index (HAQI).</p></div><div><h3>Methods</h3><p>Secondary analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2019. The ASMR and the age-specific DALY rate were reported for the years 1990, 2005, and 2019. Correlation between age-specific DALY rate with SDI and HAQI was estimated.</p></div><div><h3>Results</h3><p>There were differences in the level and change in ASMR and the age-specific DALY rates among OECD countries. Overall, men had a higher rate for both age groups in both indicators. Although the rates have been reduced between 1990 and 2019, some countries stand out for continuing to have higher rates than countries with better socioeconomic levels. The disease burden profile also differed between adults aged 65–74 years and those aged 75+ years. In almost all cases, there was a negative and statistically significant correlation between the age-specific DALY rate with SDI and HAQI.</p></div><div><h3>Conclusions</h3><p>The burden of mortality and DALY in OECD countries is convergent because they have decreased over time in all countries but diverge in the magnitude and speed of change.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0188440924001346/pdfft?md5=58b2bc2ae194092ed103b62282f86ce5&pid=1-s2.0-S0188440924001346-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142232695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

How Latin American health care systems will respond to the next crises? Lessons and challenges after the COVID-19 pandemic 拉丁美洲医疗保健系统将如何应对下一次危机？COVID-19 大流行后的教训和挑战

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-09-14 DOI: 10.1016/j.arcmed.2024.103069

引用次数: 0

Impact on Fatality Rates and Years of Life Lost During the COVID-19 Pandemic: The Experience of the Mexican Public Health Incident Management Command COVID-19 大流行期间对死亡率和生命损失年数的影响：墨西哥公共卫生事件管理指挥部的经验

IF 4.7 3区医学

Archives of Medical Research Pub Date : 2024-09-10 DOI: 10.1016/j.arcmed.2024.103073

{"title":"Impact on Fatality Rates and Years of Life Lost During the COVID-19 Pandemic: The Experience of the Mexican Public Health Incident Management Command","authors":"","doi":"10.1016/j.arcmed.2024.103073","DOIUrl":"10.1016/j.arcmed.2024.103073","url":null,"abstract":"<div><h3>Background</h3><p>The SARS-CoV-2 pandemic challenged health systems worldwide. In Mexico, the Public Health Incident Management Command (COISS) strategy was implemented to improve health care for patients with COVID-19 who required hospitalization.</p></div><div><h3>Aim</h3><p>To evaluate the impact of the COISS strategy on case fatality rates (CFR) and years of life lost (YLL) in hospitalized patients with COVID-19.</p></div><div><h3>Materials and Methods</h3><p>The COISS strategy included eight actions implemented in states with high epidemic risk (COISS states). A secondary analysis of the public database from the Mexican Ministry of Health was performed considering patients with confirmed diagnoses of SARS-CoV-2 infection. The COISS strategy effectiveness was evaluated by its impact on in-hospital CFR and YLL at the beginning (T0) and end (T1) of the third wave, and at the end of the fourth wave (T2) and compared to states without intervention (non-COISS states).</p></div><div><h3>Results</h3><p>At T0, COISS states showed a higher CFR for hospitalized patients than non-COISS states, which decreased after the strategy implementation. After correction for baseline conditions, lower relative CFR at T1 and T2, compared to T0, and a protective effect in different age groups, especially in those ≥65 years, were found in hospitalized patients in COISS states. The COISS strategy was associated with lower CFR in hospitalized patients with COVID-19 at both T1 and T2. At T0, YLLs were higher in COISS states, but there were no significant differences at T1 and T2.</p></div><div><h3>Conclusions</h3><p>COISS interventions effectively reduced CFR in hospitalized patients with COVID-19, providing protection to vulnerable patients and reducing the YLL gap.</p></div>","PeriodicalId":8318,"journal":{"name":"Archives of Medical Research","volume":null,"pages":null},"PeriodicalIF":4.7,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0188440924001255/pdfft?md5=41309efeadb3c41a7dd3f684e8de839b&pid=1-s2.0-S0188440924001255-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142162893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0