ABSTRACT Equity has become a key objective for the Pan American Health Organization (PAHO). This is the result of multidimensional movements with a history that can only be understood in the light of social relations that structure the processes we refer to as "health". From an initial concern for maritime trade to a current interest in the social determinants of health, PAHO has strengthened its efforts to make the concept of health equity the ultimate goal of its actions. The idea of health focused on the individual has given way to the idea of health for all people, which considers the differences between being and doing in the world. These changes have produced policies, analyses, and studies in which gender and cultural diversity are cross-cutting themes that must be considered in all planning and implementation of health policies in the Region of the Americas. This article discusses milestones on the road to health equity in the Region from a historical perspective.

RESUMO Hoje, a equidade é um objetivo central para a Organização Pan-Americana da Saúde (OPAS). Esse objetivo é fruto de movimentos multidimensionais que têm uma história e que só podem ser compreendidos à luz das relações sociais que estruturam os processos que chamamos de “saúde”. Da preocupação com o comércio marítimo ao interesse pelos determinantes sociais da saúde, a OPAS tem intensificado seus esforços para colocar no cerne de suas ações a ideia da equidade em saúde como objetivo final. Passou de uma ideia de saúde centrada no indivíduo a uma ideia de saúde para todas as pessoas, que contempla as diferenças entre o ser e o fazer no mundo. Essas mudanças produziram políticas, análises e estudos onde o gênero e a diversidade cultural são eixos transversais que devem ser considerados em todo planejamento e execução de políticas de saúde na Região das Américas. Este artigo analisa momentos-chave no caminho rumo à equidade em saúde na região, a partir de uma perspectiva histórica.

RESUMEN Hoy en día la equidad es un objetivo central para la Organización Panamericana de la Salud (OPS). Este objetivo es el resultado de movimientos multidimensionales que tienen una historia y que sólo pueden comprenderse a la luz de las relaciones sociales que estructuran los procesos que llamamos de “salud”. De una preocupación por el comercio marítimo a un interés por los determinantes sociales de la salud, la OPS ha fortalecido sus esfuerzos por poner en el centro de sus acciones la idea de la equidad en salud como fin último. Se ha pasado de una idea de salud enfocada en el individuo, a una idea de salud para todas las personas, que contemple las diferencias de ser y hacer en el mundo. Estos cambios han producido políticas, análisis y estudios donde el género y la diversidad cultural son ejes transversales que deben ser contemplados en toda planificación y ejecución de políticas de salud en la Región de las Américas. En este artículo se analizan momentos clave en el camino hacia la equidad en salud en la Región desde una perspectiva histórica.

Esta revisión sistemática y metanálisis ha tenido como objetivo definir la eficacia de la erradicación de Helicobacter pylori sobre la prevención del cáncer gástrico. Realizamos una revisión de la literatura utilizando las principales bases de datos como PUBMED, EMBASE, CINAHL (EBSCO), Google académico, LILACS, Cochrane, ProQuest, disertaciones y tesis, obteniendo 3934 referencias, aplicando los criterios de inclusión y exclusión se seleccionaron 7 experimentos clínicos aleatorizados controlados. Utilizando la valoración de riesgo de sesgos de Cochrane, se evaluó la calidad de los estudios. El análisis estadístico se realizó con REVMAN 5.2. Con un total de 5.552 sujetos, se encontró desarrollo de cáncer gástrico en 55 (2,41%) de 2278 pacientes a quienes se erradicó el H. pylori y en 96 (4,22%) de 2.272 a quienes no se les erradicó, RR: 0,57 (IC= 0,42-0,79). El tiempo de seguimiento osciló entre 3 y 15 años. El análisis de heterogeneidad (Chi cuadrado) tuvo un valor de p no significativo (p= 0,48) confirmando la NO presencia heterogeneidad, permitiendo el metanálisis. Con el gráfico de embudo (Funnel Plot), se descartó el sesgo de publicación y el análisis de sensibilidad no mostró cambios significativos. En conclusión, este estudio sugiere que la erradicación del H. pylori disminuye el riesgo de cáncer gástrico, particularmente en poblaciones de alto riesgo, con una calidad de evidencia moderada. Recomendando en la práctica, la terapia de erradicación de H. pylori como medida de prevención

The aim of this systematic review and meta-analysis is to determine the efficacy of eradicating Helicobacter pylori for prevention of gastric cancer. We conducted a literature review using major databases including PUBMED, EMBASE, CINAHL (EBSCO), Google Scholar, LILACS, Cochrane, ProQuest Dissertations and Theses. Seven experiments were selected out of the 3,934 references obtained by applying our inclusion and exclusion criteria. All seven were randomized controlled trials. The quality of the studies was assessed with the Cochrane assessment of risk of bias. Statistical analysis was performed with REVMAN 5.2. Out of a total of 5,552 subjects, 55 (2.41%) of the 2,278 patients who had had H. pylori eradicated developed gastric cancer, but 96 (4.22%) of the 2,272 patients who had not had the bacteria eradicated developed gastric cancer (RR: 0.57, CI = 0.42 to 0.79). Follow-up time ranged from 3 to 15 years. The analysis of heterogeneity (Chi square) had a non-significant p value (p = 0.48) confirming the absence of heterogeneity and allowing the meta-analysis. Funnel Plot analysis was used to discard publication bias, and the sensitivity analysis showed no significant changes. In conclusion, this study suggests that eradication of H. pylori reduces the risk of gastric cancer, particularly in high-risk populations with medium quality evidence. We recommend the practice of using eradicate of H. pylori as a preventive measure

Between 1986 and 1987 fishes distributed among the following species introduced in Chile, and from different sectors of the Valdivia river basin (39º30' - 40º00', 73º30' - 71º45'W), were examined: 348 Salmo trutta, 242 Salmo gairdneri, 24 Cyprinus carpio and 52 Gambusia affinis holbrooki. The presence of Camallanus corderoi and Contracaecum sp. in S. gairdneri and of C. corderoi in S. trutta is recorded in Chile for the first time. Cyprinus carpio and G. a. holbrooki did not present infections by nematodes. The prevalence and mean intensity of the infections by nematodes presented significant differences among some sectors of the Valdivia river basin. In general, the prevalence and intensity of the infections by C. corderoi were greater than those by Contracaecum sp. The infections in S. gairdneri were higher than in S. trutta. The sex of the hosts had no influence on the prevalence and intensity of the infections by both nematodes. The length of the hosts did have an influence, except in the case of the infections by Contracaecum sp. in S, gairdneri. The infrapopulations of both nematode species showed over dispersion in most cases. The diet of the examined salmonids suggests that they would become infected principally throught the consuption of autochthonous fishes.