RESUMO Objetivo. Mapear protocolos de pesquisa, publicações e colaborações sobre a doença causada pelo coronavírus 2019 (COVID-19, na sigla em inglês) desenvolvidos na América Latina e no Caribe (ALC). Métodos. Foram incluídos protocolos registrados em plataformas internacionais e publicações de pesquisas que consideraram população, dados e autores da ALC. A fonte de informação para os protocolos foi principalmente a Plataforma Internacional de Registros de Ensaios Clínicos (ICTRP, na sigla em inglês) da Organização Mundial da Saúde. Para as publicações, foram utilizadas bases de dados eletrônicas e repositórios específicos sobre COVID-19. As publicações foram pesquisadas até 11 de novembro, e os protocolos, até 30 de novembro de 2020 (inclusive). As informações dos protocolos foram extraídas de acordo com variáveis padronizadas da plataforma ICTRP e das publicações, segundo critérios pré-estabelecidos. Resultados. Dos protocolos, 63% eram estudos sobre terapias, 10% sobre prevenção e 45% eram colaborativos. Em relação ao financiamento, 64% dos protocolos não vieram da indústria. Em relação às publicações, 23% eram sem revisão por pares e 23% eram colaborativas. Os delineamentos mais frequentes foram revisões sistemáticas e estudos transversais; 47,1% foram realizados em serviços de saúde e 22% no âmbito comunitário; 38,0% focaram no diagnóstico e 27,9% no prognóstico. Realizou-se uma síntese qualitativa segundo a linha de cuidado e as estratégias de abordagem. Conclusões. Observou-se um aumento no número de pesquisas colaborativas (em comparação com estudos anteriores) e de protocolos não financiados pela indústria. A agenda de pesquisa proposta foi coberta, em grande parte, à medida que a pandemia progredia.

ABSTRACT Objective. To map research protocols, publications, and collaborations on coronavirus disease 2019 (COVID-19) developed in Latin America and the Caribbean (LAC). Methods. Included were research protocols registered in international platforms and research publications containing populations, data, or authors from LAC. The source of information for protocols was primarily the International Clinical Trial Registry Platform (ICTRP) of the World Health Organization; for publications, specific electronic databases and repositories pertaining to COVID-19 were used. The search for publications was conducted up to 11 November; the search for protocols, up to 30 November 2020 (both dates inclusive). Data was extracted from protocols using standardized variables from the ICTRP, and from publications following pre-established criteria. Results. Among the protocols, 63.0% were therapeutic studies, 10% focused on prevention, and 45% were collaborative; 64% of the protocols received no funding from industry; 23% of the publications were not peer-reviewed and 23% were collaborative in nature. The most frequent study designs were systematic reviews and cross-sectional studies; 47.1% of studies were conducted in health facilities and 22% in community settings; 38.0% focused on diagnosis and 27.9% on prognosis. A qualitative synthesis was performed by line of care and approach strategies. Conclusions. There was an increase in the number of collaborative research studies relative to earlier studies and in protocols not funded by industry. The proposed research agenda was covered in large part as the pandemic unfolded.

RESUMEN Objetivo. Mapear protocolos de investigación, publicaciones y colaboraciones sobre la enfermedad por el coronavirus 2019 (COVID-19, por su sigla en inglés) desarrollados en América Latina y el Caribe (ALC). Métodos. Se incluyeron protocolos registrados en plataformas internacionales y publicaciones de investigaciones que consideraron población, datos y autores de ALC. La fuente de información para los protocolos fue principalmente la Plataforma Internacional de Registro de Ensayos Clínicos (ICTRP, por su sigla en inglés) de la Organización Mundial de la Salud; para las publicaciones se utilizaron bases electrónicas y repositorios específicos sobre la COVID-19. Se realizaron búsquedas de las publicaciones hasta el 11 de noviembre y de los protocolos hasta el día 30 de noviembre de 2020, inclusive. La información de los protocolos se extrajo según variables estandarizadas de la plataforma ICTRP y la de las publicaciones, según criterios preestablecidos. Resultados. De los protocolos, 63,0% fueron estudios sobre terapias, 10% de prevención y 45% fueron colaborativos. Con respecto al financiamiento, 64% de los protocolos no provino de la industria. En cuanto a las publicaciones, 23% fueron sin revisión de pares y 23% fueron colaborativas. Los diseños más frecuentes fueron las revisiones sistemáticas y estudios de corte transversal; 47,1% fueron realizados en servicios de salud y 22% en el ámbito comunitario; 38,0% se enfocaron en el diagnóstico y 27,9% en el pronóstico. Se realizó una síntesis cualitativa según la línea de cuidado y las estrategias de abordaje. Conclusiones. Se observó un aumento del número de investigaciones colaborativas en comparación con estudios anteriores y de protocolos no financiados por la industria. La agenda de investigación propuesta se cubrió en gran parte conforme al avance de la pandemia.

Abstract We present the case of a 54-year-old patient who presented with a history of 2 years with angina. Invasive studies revealed critical coronary artery stenosis coexisting with obstructive hypertrophic miopathy. This is a rare association with only isolated case reports.

Resumen Se presenta el caso de un paciente de 54 años que consulta por angina de esfuerzo de 2 años de evolución en quien se identifica una dilatación ectásica del árbol coronario con lesiones ateroscleróticas críticas y miocardiopatía hipertrófica septal obstructiva. Una revisión bibliográfica revela que es una asociación infrecuente de la cual solo existen reportes de casos aislados.

ABSTRACT Objective Synthesize evidence on effectiveness of interventions designed to improve access to health services by indigenous populations. Methods Review of systematic reviews published as of July 2015, selecting and analyzing only studies in the Region of the Americas. The bibliographic search encompassed MEDLINE, Lilacs, SciELO, EMBASE, DARE, HTA, The Cochrane Library, and organization websites. Two independent reviewers selected studies and analyzed their methodological quality. A narrative summary of the results was produced. Results Twenty-two reviews met the inclusion criteria. All selected studies were conducted in Canada and the United States of America. The majority of the interventions were preventive, to surmount geographical barriers, increase use of effective measures, develop human resources, and improve people’s skills or willingness to seek care. Topics included pregnancy, cardiovascular risk factors, diabetes, substance abuse, child development, cancer, mental health, oral health, and injuries. Some interventions showed effectiveness with moderate or high quality studies: educational strategies to prevent depression, interventions to prevent childhood caries, and multicomponent programs to promote use of child safety seats. In general, results for chronic non-communicable diseases were negative or inconsistent. Conclusions Interventions do exist that have potential for producing positive effects on access to health services by indigenous populations in the Americas, but available studies are limited to Canada and the U.S. There is a significant research gap on the topic in Latin America and the Caribbean.

RESUMEN Objetivo Sintetizar la evidencia sobre la efectividad de intervenciones diseñadas para mejorar el acceso de los pueblos indígenas a los servicios de salud. Métodos Revisión de revisiones sistemáticas publicadas hasta julio de 2015, de las cuales se seleccionaron y analizaron solamente los estudios realizados en la Región de las Américas. La búsqueda bibliográfica abarcó Medline, Lilacs, Scielo, EMBASE, DARE, HTA, The Cochrane Library y sitios web de organizaciones. Dos revisores independientes seleccionaron los estudios y analizaron su calidad metodológica. Se realizó una síntesis narrativa de los resultados. Resultados Veintidós revisiones cumplieron los criterios de inclusión. Todos los estudios seleccionados se realizaron en Canadá y Estados Unidos de América (EE.UU.). La mayoría de las intervenciones fueron preventivas, para sortear barreras geográficas, aumentar el uso de medidas efectivas, desarrollar recursos humanos y mejorar las destrezas o disposición de las personas para atenderse. Los temas incluyeron embarazo, factores de riesgo cardiovascular, diabetes, abuso de sustancias, desarrollo infantil, cáncer, salud mental, oral y lesiones. Algunas intervenciones mostraron efectividad con estudios de calidad moderada o alta: estrategias educativas para prevención de depresión, intervenciones para prevención de caries infantiles y programas multicomponente para promover el uso de asientos de seguridad en niños. En enfermedades crónicas no transmisibles los resultados fueron en general negativos o inconsistentes. Conclusiones Existen algunas intervenciones que tienen potencial de producir efectos positivos en el acceso a los servicios de salud de las poblaciones indígenas en las Américas, pero los estudios disponibles se limitan a Canadá y EE.UU. Existe una significativa brecha de investigación sobre el tema en América Latina y el Caribe.

RESUMEN Se realizó un estudio con el objeto de evaluar el posible efecto tóxico de un extracto acuoso liofilizado de Werneria dactylophylla (Pupusa) reconocida por sus importantes propiedades farmacológicas. Para el desarrollo del mismo se utilizó el procedimiento de dosis fijas, utilizando dosis límite de 2000 mg/Kg y 5000 mg/Kg de peso corporal, administradas por vía orogástrica, realizándose observaciones durante 14 días. Los animales seleccionados fueron ratones Swiss albinos hembras con un peso comprendido entre 18 y 20 g. Los resultados demostraron la inocuidad de la planta al no observarse signos ni síntomas de toxicidad. El peso corporal se comportó acorde a la curva de crecimiento de la especie y no se apreciaron alteraciones macroscópicas en los órganos estudiados, todo lo que permite afirmar que la DL50 se ubica por encima de 5000 mg/Kg, considerándose el producto como no tóxico según el criterio de Williams. La metodología y el diseño experimental se llevó a cabo siguiendo la orientación descrita por la norma EPA (Agencia de Protección Ambiental) 870.1100, OECD 425 (Organización Económica para el Comercio y Desarrollo), que abarca las 24 naciones más desarrolladas del mundo, para la aplicación del método de las Clases de Toxicidad Aguda (CTA)

           A study was conducted to evaluate the potential toxic effect of a lyophilized aqueous extract of Werneria dactylophylla (Pupusa) recognized for their important pharmacological properties. For its development we used the fixed dose procedure, using a limit dose of 2000 mg / kg and 5000 mg / kg of body weight, administered by orogastric route for 14 days performing observations. The selected animals were female albino Swiss mice weighing between 18 and 20 g. Results demonstrated the safety of the plant with no signs or symptoms of toxicity observed. Body weight behaved according to the growth curve of the species and there were no gross abnormalities in the studied organs, allowing to say that the LD50 is above 5000 mg / kg, considering the product as nontoxic as the Williams’ criterion. The methodology and experimental design was conducted along the lines described by the standard EPA (Environmental Protection Agency) 870.1100, OECD 425 (Organization for Economic Trade and Development), which covers the 24 most developed nations of the world, for applying the method of Acute Toxicity Class (CTA)

Background: Among women, risk factors for mental disorders are violence, economical inequities and disadvantages and discrimination. Aim: To determine the prevalence of anxiety and depressive symptoms in women and to determine factors associated with them. Material and methods: A cross sectional study of a probabilistic sample of 422 women aged 34 years as a mean, living in a medium to low income neighborhood in Temuco, Chile. Mental health was assessed with the self reporting questionnaire (SRQ20), partner violence was evaluated using a 12 item scale and family conflict and violence was evaluated using the Conflicts Tactics scale. A logistic repression analysis was used to identify factors associated with mental health alterations. Results: Forty one percent of women had anxiety or depressive symptoms. The main associated factors with these symptoms were severe physical violence against children (odds ratio (OR) =14.3), sexual violence against women (OR =9.7), self perception of health (OR =4.5), alcohol abuse (OR =4.4), psychological violence during childhood (OR =3.2) and lack of family support network (OR =2.7). Unemployment and lack of a support network of relatives had an OR 3.3 for mental health alterations. The OR for psychological violence plus sexual violence was 18.5. The figure for psychological violence plus sexual violence plus a history of parental violence during childhood was 26.5. Conclusions: Forty one percent of this group of women had mental health alterations. There is a strong association between these alterations, family violence and socioeconomic factors

Background: Depression is an important mental health problem. The Chilean Ministry of Health has considered depression in women as one of the health priorities for the country. Aim: To assess the prevalence of depressive and somatic symptoms and their risk factors in climacteric women. Material and methods: A special questionnaire was applied to 171 women (45 to 55 years of age), coming from a community organization (PRODEMU) and a private health institution (ISAPRE Banmedica). Risk factors for depression were determined using multiple logistic regression. Results: The prevalence of depressive symptoms was 43%. Women with primary education had an odds ratio for depression of 2.49, compared with women with high school or university education. Other risk factor for depression was the lack of a remunerated job (Odds ratio 1.9). The risk factors for somatic symptoms were the presence of depressive symptoms (OR 3.2), lack of secondary or university education (OR 2.4), low income (OR 1.9) and having a current partner (OR 3.6). Conclusions: There is a high prevalence of depressive symptoms in the studied population of climacteric women. Lack of education and of a remunerated job are important risk factors for the presence of such symptoms. Women with a low level of education and with depressive symptoms have also a high risk of presenting somatic symptoms (Rev Méd Chile 2002; 130: 885-91)