The international development environment is entering a chaotic and volatile period.The world economy remains sluggish,while geopolitical conflicts,climate change,food crisis and a multitude of other challenges become...The international development environment is entering a chaotic and volatile period.The world economy remains sluggish,while geopolitical conflicts,climate change,food crisis and a multitude of other challenges become more closely intertwined and mutually reinforcing.In this context,countries across the world have been prompted to look for healthy,feasible and sustainable solutions to keep their socioeconomic development momentum on track.展开更多
BACKGROUND A progressive decrease in exclusive breastfeeding(BF)is observed in Latin America and the Caribbean compared with global results.The possibility of being breastfed and continuing BF for>6 months is lower...BACKGROUND A progressive decrease in exclusive breastfeeding(BF)is observed in Latin America and the Caribbean compared with global results.The possibility of being breastfed and continuing BF for>6 months is lower in low birth weight than in healthy-weight infants.AIM To identify factors associated with BF maintenance and promotion,with particular attention to low-and middle-income countries,by studying geographic,socioeconomic,and individual or neonatal health factors.METHODS A scoping review was conducted in 2018 using the conceptual model of social determinants of health published by the Commission on Equity and Health Inequalities in the United States.The extracted data with common characteristics were synthesized and categorized into two main themes:(1)Sociodemographic factors and proximal determinants involved in the initiation and maintenance of BF in low-birth-weight term infants in Latin America;and(2)individual characteristics related to the self-efficacy capacity for BF maintenance and adherence in low-birth-weight term infants.RESULTS This study identified maternal age,educational level,maternal economic capacity,social stratum,exposure to BF substitutes,access to BF information,and quality of health services as mediators for maintaining BF.CONCLUSION Individual self-efficacy factors that enable BF adherence in at-risk populations should be analyzed for better health outcomes.展开更多
Traditional Chinese medicine(TCM) arrived from China to Latin America and the Caribbean in the 1840s due to the massive migration of Chinese people to the region. In a few years, the press noticed the presence of Chin...Traditional Chinese medicine(TCM) arrived from China to Latin America and the Caribbean in the 1840s due to the massive migration of Chinese people to the region. In a few years, the press noticed the presence of Chinese herbalists practicing in different cities and countries regardless of the demographic weight of the Chinese community. The fascination with Chinese doctors implicated not only the press but also the literature, a phenomenon particularly observed in Cuba. In the first decades of the 20th century, the reactivation of Chinese immigration to the region fostered an anti-Chinese climate that materialized in more significant migratory restrictions and control of their businesses, such as what happened with Chinese herbalists. These herbalists who practiced inside and outside the Chinese community started to object to criticism and persecution by the conservative press and professional doctors. Despite this, Chinese doctors will continue to maintain their support of a significant number of ill persons. This work seeks to illuminate the historical relevance of TCM in Latin America and the Caribbean, focusing on the cases of Peru, Chile, and Cuba. This last country was far from China culturally and geographically, but as in many other small towns in the region, Chinese medicine presented an alternative to the treatment of illnesses.展开更多
The increasing prevalence of technology in society has an impact on young people’s language use and development. Greeklish is the writing of Greek texts using the Latin instead of the Greek alphabet, a practice known...The increasing prevalence of technology in society has an impact on young people’s language use and development. Greeklish is the writing of Greek texts using the Latin instead of the Greek alphabet, a practice known as Latinization, also employed for many non-latin alphabet languages. The primary aim of this research is to evaluate the effect of Greeklish on reading time. A sample of 732 young Greeks were asked about their habits when communicating through e-mail and social media with their friends and they then participated in an experiment in which they were asked to read and understand two short texts, one written in Greek and the other in Greeklish. The findings of the research show that nearly one third of the participants use Greeklish. The results of the experiment conducted reveal that understanding is not affected by the alphabet used but reading Greeklish is significantly more time consuming than reading Greek independently of the sex and the familiarity of the participants with Greeklish. The findings suggest that amending social and communication media with software utilities related to Latinization such as language identifiers and converters may reduce reading time and thus facilitate written communication among the users.展开更多
In a world of Google and AI, developing an encyclopedic coverage of a theme that is of great interest to biologists, social scientists, politicians and environmental managers, is a daunting challenge. Wattles is a boo...In a world of Google and AI, developing an encyclopedic coverage of a theme that is of great interest to biologists, social scientists, politicians and environmental managers, is a daunting challenge. Wattles is a book that presents new knowledge, makes interesting reading, and has the potential to stimulate research in a variety of disciplines. We learn that Acacia, commonly known as the wattles or acacias, is a genus of shrubs and trees comprising 1,083 species of which 417 are known to have been introduced to areas outside their native range. We are surprised to read that Australian acacias are found almost everywhere, in virtually all terrestrial habitats, including woodlands, grasslands, alpine settings,rainforests, coastal dunes and deserts, causing major environmental and socio-economic changes in the invaded regions. Until recently, Acacia comprised a group of plant species native to Africa, South America and Australasia, but the name is now reserved for species predominantly from Australia, including some from Southeast Asia. The genus name Acacia is Neo-Latin, and refers to a preparation extracted from the leaves and fruit pods of Vachellia nilotica, the original type of the genus.展开更多
The word “senescence” comes from the Latin senescens, meaning “to begin to age”, and is characterized by a long-lasting but reversible block in proliferation, resulting from stress-induced cell cycle arrest of pre...The word “senescence” comes from the Latin senescens, meaning “to begin to age”, and is characterized by a long-lasting but reversible block in proliferation, resulting from stress-induced cell cycle arrest of previously replication-competent cells.展开更多
Spatial variability of soil properties imposes a challenge for practical analysis and design in geotechnical engineering.The latter is particularly true for slope stability assessment,where the effects of uncertainty ...Spatial variability of soil properties imposes a challenge for practical analysis and design in geotechnical engineering.The latter is particularly true for slope stability assessment,where the effects of uncertainty are synthesized in the so-called probability of failure.This probability quantifies the reliability of a slope and its numerical calculation is usually quite involved from a numerical viewpoint.In view of this issue,this paper proposes an approach for failure probability assessment based on Latinized partially stratified sampling and maximum entropy distribution with fractional moments.The spatial variability of geotechnical properties is represented by means of random fields and the Karhunen-Loève expansion.Then,failure probabilities are estimated employing maximum entropy distribution with fractional moments.The application of the proposed approach is examined with two examples:a case study of an undrained slope and a case study of a slope with cross-correlated random fields of strength parameters under a drained slope.The results show that the proposed approach has excellent accuracy and high efficiency,and it can be applied straightforwardly to similar geotechnical engineering problems.展开更多
In 2023, Latin America was confronted with increased domestic and international challenges, resulting in a stronger public desire for change. New social ideologies are continuing to emerge, and transformation through ...In 2023, Latin America was confronted with increased domestic and international challenges, resulting in a stronger public desire for change. New social ideologies are continuing to emerge, and transformation through reform has become a broad consensus. However, during the complicated reshaping of Latin America's political ecology, the swing of the political pendulum and the change of regimes are accelerating.展开更多
Currently,a new round of economic reform is catching up pace in Latin American and the Caribbean countries.This round of reform coincides with a new wave of leftist governments in this region.Driven by the severe econ...Currently,a new round of economic reform is catching up pace in Latin American and the Caribbean countries.This round of reform coincides with a new wave of leftist governments in this region.Driven by the severe economic dilemma and social conflicts,Latin American and Caribbean countries have initiated a new round of economic reform by strengthening the state's role in the economy,transforming production modes,improving fiscal and monetary functions,and emphasizing income distribution and social equality,which achieved both economic and social effects.This round of reform has had a certain impact at both the regional and global levels,not only activating the sluggish integration of this region,but also reflecting the development demands of the Global South for transformation and independence.The adjustment of interests brought about by the new round of economic reform in Latin America and the Caribbean will also bring new development opportunities for Sino–Latin American relations.展开更多
UPON the establishment of European universities in the Middle Ages,the educational system in Western countries became characterized by an essentially Eurocentric worldview.This was reflected in the study of Latin and ...UPON the establishment of European universities in the Middle Ages,the educational system in Western countries became characterized by an essentially Eurocentric worldview.This was reflected in the study of Latin and Greek in high school,and in basing public life and political systems on philosophies of classical antiquity.The work of the influential Chinese philosopher Confucius(551-479 B.C.),a near-contemporary of the major Greek philosophers Socrates(469-399 B.C.),Plato(428-348 B.C.)and Aristotle(384-322 B.C.),whose ethical and political ideas entered into the constitutions of European states,remained unknown.展开更多
Time is an important part of life.Different cultures view time in different ways.In places such as the U.S.,Germanyand Japan,peoplevaluetime very much.They begin and end activities ontime.ForpeoplefromLatinAmericaand ...Time is an important part of life.Different cultures view time in different ways.In places such as the U.S.,Germanyand Japan,peoplevaluetime very much.They begin and end activities ontime.ForpeoplefromLatinAmericaand Africa,that is not important.They are often late.But that is fine.They focus on activities.That's usualforthem.展开更多
Improving the efficiency of ship optimization is crucial for modem ship design. Compared with traditional methods, multidisciplinary design optimization (MDO) is a more promising approach. For this reason, Collabora...Improving the efficiency of ship optimization is crucial for modem ship design. Compared with traditional methods, multidisciplinary design optimization (MDO) is a more promising approach. For this reason, Collaborative Optimization (CO) is discussed and analyzed in this paper. As one of the most frequently applied MDO methods, CO promotes autonomy of disciplines while providing a coordinating mechanism guaranteeing progress toward an optimum and maintaining interdisciplinary compatibility. However, there are some difficulties in applying the conventional CO method, such as difficulties in choosing an initial point and tremendous computational requirements. For the purpose of overcoming these problems, optimal Latin hypercube design and Radial basis function network were applied to CO. Optimal Latin hypercube design is a modified Latin Hypercube design. Radial basis function network approximates the optimization model, and is updated during the optimization process to improve accuracy. It is shown by examples that the computing efficiency and robustness of this CO method are higher than with the conventional CO method.展开更多
Latin America shows one of the highest incidence rates of gastric cancer in the world,with variations in mortality rates among nations or even within countries belonging to this region.Gastric cancer is the result of ...Latin America shows one of the highest incidence rates of gastric cancer in the world,with variations in mortality rates among nations or even within countries belonging to this region.Gastric cancer is the result of a multifactorial complex process,for which a multistep model of carcinogenesis is currently accepted.Additionally to the infection with Helicobacter pylori,that plays a major role,environmental factors as well as genetic susceptibility factors are significant players at different stages in the gastric cancer process.The differences in population origin,demographic structure,socio-economic development,and the impact of globalization lifestyles experienced in Latin America in the last decades,all together offer opportunities for studying in this context the influence of genetic polymorphisms in the susceptibility to gastric cancer.The aim of this article is to discuss current trends on gastric cancer in Latin American countries and to review the available published information about studies of association of gene polymorphisms involved in gastric cancer susceptibility from this region of the world.A total of 40 genes or genomic regions and69 genetic variants,58%representing markers involved in inflammatory response,have been used in a number of studies in which predominates a low number of individuals(cases and controls)included.Polymorphisms of IL-1B(-511 C/T,14 studies;-31 T/C,10 studies)and IL-1RN(variable number of tandem repeats,17 studies)are the most represented ones in the reviewed studies.Other genetic variants recently evaluated in large metaanalyses and associated with gastric cancer risk were also analyzed in a few studies[e.g.,prostate stem cell antigen(PSCA),CDH1,Survivin].Further and better analysis centered in gene polymorphisms linked to other covariates,epidemiological studies and the information provided by meta-analyses and genome-wide association studies should help to improve our understanding of gastric cancer etiology in order to develop appropriate health programs in Latin America.展开更多
To estimate Helicobacter pylori (H. pylori) recurrence rate in Latin America, a region with a significant H. pylori prevalence and gastric cancer burden. METHODSPubMed, LILACS, SciELO, Cochrane databases and abstracts...To estimate Helicobacter pylori (H. pylori) recurrence rate in Latin America, a region with a significant H. pylori prevalence and gastric cancer burden. METHODSPubMed, LILACS, SciELO, Cochrane databases and abstracts from relevant meetings were reviewed. Information collected included: Participants’ characteristics, recruitment strategy, diagnostic modality, treatment arms, follow-up and recurrence rates. Recurrence was calculated using 100-patients-year rates, and data were pooled using a random effects model. The I<sup>2</sup> statistic assessed between study heterogeneity. Meta-regression analyses evaluated for effect modifying variables. RESULTSLiterature search yielded 163 articles. Twelve studies involving 4848 patients from 9 countries met inclusion criteria. Four hundred and thirty-two reinfections were recorded in 5487 person-years of follow-up. Pooled analysis showed a recurrence rate of 7.9 cases per 100 person-years (95%CI: 5.3-10.5). Meta-regression revealed that neither the antibiotic schema, a second antibiotic course, nor the diagnostic modality had an impact on the observed risk of recurrence. The recurrence rate in the first year after treatment, predominantly recrudescence, was 11.2 (6.1-16.4) per 100 patient years. Recurrence in subsequent years, was only 6.2 (3.8-8.7). CONCLUSIONH. pylori recurrence rates in Latin America are significant, and with geographic variability, yet are acceptable based upon the current literature for consideration of large scale intervention trials. Further research in Latin America is warranted to evaluate the efficacy, cost-effectiveness, and potential adverse outcomes of proposed eradication programs.展开更多
Latin America, a region with a population greater than 600000000 individuals, is well known due to its wide geographic, socio-cultural and economic heterogeneity. Access to health care remains as the main barrier that...Latin America, a region with a population greater than 600000000 individuals, is well known due to its wide geographic, socio-cultural and economic heterogeneity. Access to health care remains as the main barrier that challenges routine screening, early diagnosis and proper treatment of hepatocellular carcinoma(HCC). Therefore, identification of population at risk, implementation of surveillance programs and access to curative treatments has been poorly obtained in the region. Different retrospective cohort studies from the region have shown flaws in the implementation process of routine surveillance and early HCC diagnosis. Furthermore, adherence to clinical practice guidelines recommendations assessed in two studies from Brazil and Argentina demonstrated that there is also room for improvement in this field, similarly than the one observed in Europe and the United States. In summary, Latin America shares difficulties in HCC decision-making processes similar to those from developed countries. However, a transversal limitation in the region is the poor access to health care with the consequent limitation to standard treatments for overall population. Specifically, universal health care access to the different World Health Organization levels is crucial, including improvement in research, education and continuous medical training in order to expand knowledge and generation of data promoting a continuous improvement in the care of HCC patients.展开更多
Hepatitis B virus(HBV)infection is the leading cause of severe chronic liver disease.This article provides a critical view of the importance of genomic medicine for the study of HBV infection and its clinical outcomes...Hepatitis B virus(HBV)infection is the leading cause of severe chronic liver disease.This article provides a critical view of the importance of genomic medicine for the study of HBV infection and its clinical outcomes in Latin America.Three levels of evolutionary adaptation may correlate with the clinical outcomes of HBV infection.Infections in Latin America are predominantly of genotype H in Mexico and genotype F in Central and South America;these strains have historically circulated among the indigenous population.Both genotypes appear to be linked to a benign course of disease among the native and mestizo Mexicans and native South Americans.In contrast,genotypes F,A and D are common in acute and chronic infections among mestizos with Caucasian ancestry.Hepatocellular carcinoma is rare in Mexicans,but it has been associated with genotype F1b among Argentineans.This observation illustrates the significance of ascertaining the genetic and environmental factors involved in the development of HBV-related liver disease in Latin America,which contrast with those reported in other regions of the world.展开更多
文摘The international development environment is entering a chaotic and volatile period.The world economy remains sluggish,while geopolitical conflicts,climate change,food crisis and a multitude of other challenges become more closely intertwined and mutually reinforcing.In this context,countries across the world have been prompted to look for healthy,feasible and sustainable solutions to keep their socioeconomic development momentum on track.
文摘BACKGROUND A progressive decrease in exclusive breastfeeding(BF)is observed in Latin America and the Caribbean compared with global results.The possibility of being breastfed and continuing BF for>6 months is lower in low birth weight than in healthy-weight infants.AIM To identify factors associated with BF maintenance and promotion,with particular attention to low-and middle-income countries,by studying geographic,socioeconomic,and individual or neonatal health factors.METHODS A scoping review was conducted in 2018 using the conceptual model of social determinants of health published by the Commission on Equity and Health Inequalities in the United States.The extracted data with common characteristics were synthesized and categorized into two main themes:(1)Sociodemographic factors and proximal determinants involved in the initiation and maintenance of BF in low-birth-weight term infants in Latin America;and(2)individual characteristics related to the self-efficacy capacity for BF maintenance and adherence in low-birth-weight term infants.RESULTS This study identified maternal age,educational level,maternal economic capacity,social stratum,exposure to BF substitutes,access to BF information,and quality of health services as mediators for maintaining BF.CONCLUSION Individual self-efficacy factors that enable BF adherence in at-risk populations should be analyzed for better health outcomes.
基金funded by ANID—Millennium Science Initiative Program (No. NCS2022_053)。
文摘Traditional Chinese medicine(TCM) arrived from China to Latin America and the Caribbean in the 1840s due to the massive migration of Chinese people to the region. In a few years, the press noticed the presence of Chinese herbalists practicing in different cities and countries regardless of the demographic weight of the Chinese community. The fascination with Chinese doctors implicated not only the press but also the literature, a phenomenon particularly observed in Cuba. In the first decades of the 20th century, the reactivation of Chinese immigration to the region fostered an anti-Chinese climate that materialized in more significant migratory restrictions and control of their businesses, such as what happened with Chinese herbalists. These herbalists who practiced inside and outside the Chinese community started to object to criticism and persecution by the conservative press and professional doctors. Despite this, Chinese doctors will continue to maintain their support of a significant number of ill persons. This work seeks to illuminate the historical relevance of TCM in Latin America and the Caribbean, focusing on the cases of Peru, Chile, and Cuba. This last country was far from China culturally and geographically, but as in many other small towns in the region, Chinese medicine presented an alternative to the treatment of illnesses.
文摘The increasing prevalence of technology in society has an impact on young people’s language use and development. Greeklish is the writing of Greek texts using the Latin instead of the Greek alphabet, a practice known as Latinization, also employed for many non-latin alphabet languages. The primary aim of this research is to evaluate the effect of Greeklish on reading time. A sample of 732 young Greeks were asked about their habits when communicating through e-mail and social media with their friends and they then participated in an experiment in which they were asked to read and understand two short texts, one written in Greek and the other in Greeklish. The findings of the research show that nearly one third of the participants use Greeklish. The results of the experiment conducted reveal that understanding is not affected by the alphabet used but reading Greeklish is significantly more time consuming than reading Greek independently of the sex and the familiarity of the participants with Greeklish. The findings suggest that amending social and communication media with software utilities related to Latinization such as language identifiers and converters may reduce reading time and thus facilitate written communication among the users.
文摘In a world of Google and AI, developing an encyclopedic coverage of a theme that is of great interest to biologists, social scientists, politicians and environmental managers, is a daunting challenge. Wattles is a book that presents new knowledge, makes interesting reading, and has the potential to stimulate research in a variety of disciplines. We learn that Acacia, commonly known as the wattles or acacias, is a genus of shrubs and trees comprising 1,083 species of which 417 are known to have been introduced to areas outside their native range. We are surprised to read that Australian acacias are found almost everywhere, in virtually all terrestrial habitats, including woodlands, grasslands, alpine settings,rainforests, coastal dunes and deserts, causing major environmental and socio-economic changes in the invaded regions. Until recently, Acacia comprised a group of plant species native to Africa, South America and Australasia, but the name is now reserved for species predominantly from Australia, including some from Southeast Asia. The genus name Acacia is Neo-Latin, and refers to a preparation extracted from the leaves and fruit pods of Vachellia nilotica, the original type of the genus.
基金supported by the Ministry of Science and Innovation and the Spanish Research Agency through FEDER funds (PID2021-1261520B-100) (MICINN/AEI/FEDER, EU)CBM receives an institutional grant from the Fundación Ramón Areces, Spain。
文摘The word “senescence” comes from the Latin senescens, meaning “to begin to age”, and is characterized by a long-lasting but reversible block in proliferation, resulting from stress-induced cell cycle arrest of previously replication-competent cells.
基金funding support from the China Scholarship Council(CSC).
文摘Spatial variability of soil properties imposes a challenge for practical analysis and design in geotechnical engineering.The latter is particularly true for slope stability assessment,where the effects of uncertainty are synthesized in the so-called probability of failure.This probability quantifies the reliability of a slope and its numerical calculation is usually quite involved from a numerical viewpoint.In view of this issue,this paper proposes an approach for failure probability assessment based on Latinized partially stratified sampling and maximum entropy distribution with fractional moments.The spatial variability of geotechnical properties is represented by means of random fields and the Karhunen-Loève expansion.Then,failure probabilities are estimated employing maximum entropy distribution with fractional moments.The application of the proposed approach is examined with two examples:a case study of an undrained slope and a case study of a slope with cross-correlated random fields of strength parameters under a drained slope.The results show that the proposed approach has excellent accuracy and high efficiency,and it can be applied straightforwardly to similar geotechnical engineering problems.
文摘In 2023, Latin America was confronted with increased domestic and international challenges, resulting in a stronger public desire for change. New social ideologies are continuing to emerge, and transformation through reform has become a broad consensus. However, during the complicated reshaping of Latin America's political ecology, the swing of the political pendulum and the change of regimes are accelerating.
文摘Currently,a new round of economic reform is catching up pace in Latin American and the Caribbean countries.This round of reform coincides with a new wave of leftist governments in this region.Driven by the severe economic dilemma and social conflicts,Latin American and Caribbean countries have initiated a new round of economic reform by strengthening the state's role in the economy,transforming production modes,improving fiscal and monetary functions,and emphasizing income distribution and social equality,which achieved both economic and social effects.This round of reform has had a certain impact at both the regional and global levels,not only activating the sluggish integration of this region,but also reflecting the development demands of the Global South for transformation and independence.The adjustment of interests brought about by the new round of economic reform in Latin America and the Caribbean will also bring new development opportunities for Sino–Latin American relations.
文摘UPON the establishment of European universities in the Middle Ages,the educational system in Western countries became characterized by an essentially Eurocentric worldview.This was reflected in the study of Latin and Greek in high school,and in basing public life and political systems on philosophies of classical antiquity.The work of the influential Chinese philosopher Confucius(551-479 B.C.),a near-contemporary of the major Greek philosophers Socrates(469-399 B.C.),Plato(428-348 B.C.)and Aristotle(384-322 B.C.),whose ethical and political ideas entered into the constitutions of European states,remained unknown.
文摘Time is an important part of life.Different cultures view time in different ways.In places such as the U.S.,Germanyand Japan,peoplevaluetime very much.They begin and end activities ontime.ForpeoplefromLatinAmericaand Africa,that is not important.They are often late.But that is fine.They focus on activities.That's usualforthem.
文摘Improving the efficiency of ship optimization is crucial for modem ship design. Compared with traditional methods, multidisciplinary design optimization (MDO) is a more promising approach. For this reason, Collaborative Optimization (CO) is discussed and analyzed in this paper. As one of the most frequently applied MDO methods, CO promotes autonomy of disciplines while providing a coordinating mechanism guaranteeing progress toward an optimum and maintaining interdisciplinary compatibility. However, there are some difficulties in applying the conventional CO method, such as difficulties in choosing an initial point and tremendous computational requirements. For the purpose of overcoming these problems, optimal Latin hypercube design and Radial basis function network were applied to CO. Optimal Latin hypercube design is a modified Latin Hypercube design. Radial basis function network approximates the optimization model, and is updated during the optimization process to improve accuracy. It is shown by examples that the computing efficiency and robustness of this CO method are higher than with the conventional CO method.
文摘Latin America shows one of the highest incidence rates of gastric cancer in the world,with variations in mortality rates among nations or even within countries belonging to this region.Gastric cancer is the result of a multifactorial complex process,for which a multistep model of carcinogenesis is currently accepted.Additionally to the infection with Helicobacter pylori,that plays a major role,environmental factors as well as genetic susceptibility factors are significant players at different stages in the gastric cancer process.The differences in population origin,demographic structure,socio-economic development,and the impact of globalization lifestyles experienced in Latin America in the last decades,all together offer opportunities for studying in this context the influence of genetic polymorphisms in the susceptibility to gastric cancer.The aim of this article is to discuss current trends on gastric cancer in Latin American countries and to review the available published information about studies of association of gene polymorphisms involved in gastric cancer susceptibility from this region of the world.A total of 40 genes or genomic regions and69 genetic variants,58%representing markers involved in inflammatory response,have been used in a number of studies in which predominates a low number of individuals(cases and controls)included.Polymorphisms of IL-1B(-511 C/T,14 studies;-31 T/C,10 studies)and IL-1RN(variable number of tandem repeats,17 studies)are the most represented ones in the reviewed studies.Other genetic variants recently evaluated in large metaanalyses and associated with gastric cancer risk were also analyzed in a few studies[e.g.,prostate stem cell antigen(PSCA),CDH1,Survivin].Further and better analysis centered in gene polymorphisms linked to other covariates,epidemiological studies and the information provided by meta-analyses and genome-wide association studies should help to improve our understanding of gastric cancer etiology in order to develop appropriate health programs in Latin America.
基金Supported by In part grants from the United States National Institutes of Health,Nos.CA1255884,CA167773,CA028842(to Morgan DR)
文摘To estimate Helicobacter pylori (H. pylori) recurrence rate in Latin America, a region with a significant H. pylori prevalence and gastric cancer burden. METHODSPubMed, LILACS, SciELO, Cochrane databases and abstracts from relevant meetings were reviewed. Information collected included: Participants’ characteristics, recruitment strategy, diagnostic modality, treatment arms, follow-up and recurrence rates. Recurrence was calculated using 100-patients-year rates, and data were pooled using a random effects model. The I<sup>2</sup> statistic assessed between study heterogeneity. Meta-regression analyses evaluated for effect modifying variables. RESULTSLiterature search yielded 163 articles. Twelve studies involving 4848 patients from 9 countries met inclusion criteria. Four hundred and thirty-two reinfections were recorded in 5487 person-years of follow-up. Pooled analysis showed a recurrence rate of 7.9 cases per 100 person-years (95%CI: 5.3-10.5). Meta-regression revealed that neither the antibiotic schema, a second antibiotic course, nor the diagnostic modality had an impact on the observed risk of recurrence. The recurrence rate in the first year after treatment, predominantly recrudescence, was 11.2 (6.1-16.4) per 100 patient years. Recurrence in subsequent years, was only 6.2 (3.8-8.7). CONCLUSIONH. pylori recurrence rates in Latin America are significant, and with geographic variability, yet are acceptable based upon the current literature for consideration of large scale intervention trials. Further research in Latin America is warranted to evaluate the efficacy, cost-effectiveness, and potential adverse outcomes of proposed eradication programs.
文摘Latin America, a region with a population greater than 600000000 individuals, is well known due to its wide geographic, socio-cultural and economic heterogeneity. Access to health care remains as the main barrier that challenges routine screening, early diagnosis and proper treatment of hepatocellular carcinoma(HCC). Therefore, identification of population at risk, implementation of surveillance programs and access to curative treatments has been poorly obtained in the region. Different retrospective cohort studies from the region have shown flaws in the implementation process of routine surveillance and early HCC diagnosis. Furthermore, adherence to clinical practice guidelines recommendations assessed in two studies from Brazil and Argentina demonstrated that there is also room for improvement in this field, similarly than the one observed in Europe and the United States. In summary, Latin America shares difficulties in HCC decision-making processes similar to those from developed countries. However, a transversal limitation in the region is the poor access to health care with the consequent limitation to standard treatments for overall population. Specifically, universal health care access to the different World Health Organization levels is crucial, including improvement in research, education and continuous medical training in order to expand knowledge and generation of data promoting a continuous improvement in the care of HCC patients.
基金Supported by The National Council of Science and Technology,Fondo Sectorial Salud-2010-1-139085the Jalisco State Council of Science and Technology,COECYTJAL-Universidad de Guadalajara 5-2010-1-1041 to Roman S,Guadalajara,Jalisco,Mexico
文摘Hepatitis B virus(HBV)infection is the leading cause of severe chronic liver disease.This article provides a critical view of the importance of genomic medicine for the study of HBV infection and its clinical outcomes in Latin America.Three levels of evolutionary adaptation may correlate with the clinical outcomes of HBV infection.Infections in Latin America are predominantly of genotype H in Mexico and genotype F in Central and South America;these strains have historically circulated among the indigenous population.Both genotypes appear to be linked to a benign course of disease among the native and mestizo Mexicans and native South Americans.In contrast,genotypes F,A and D are common in acute and chronic infections among mestizos with Caucasian ancestry.Hepatocellular carcinoma is rare in Mexicans,but it has been associated with genotype F1b among Argentineans.This observation illustrates the significance of ascertaining the genetic and environmental factors involved in the development of HBV-related liver disease in Latin America,which contrast with those reported in other regions of the world.