Introduction: The historical development, frequency, and impact of frontotemporal dementia (FTD) are less clear in Latin America than in high-income countries. Although there is a growing number of dementia studies in Latin America, little is known collectively about FTD prevalence studies by country, clinical heterogeneity, risk factors, and genetics in Latin American countries.Methods: A systematic review was completed, aimed at identifying the frequency, clinical heterogeneity, and genetics studies of FTD in Latin American populations. The search strategies used a combination of standardized terms for FTD and related disorders. In addition, at least one author per Latin American country summarized the available literature. Collaborative or regional studies were reviewed during consensus meetings.Results: The first FTD reports published in Latin America were mostly case reports. The last two decades marked a substantial increase in the number of FTD research in Latin American countries. Brazil (165), Argentina (84), Colombia (26), and Chile (23) are the countries with the larger numbers of FTD published studies. Most of the research has focused on clinical and neuropsychological features (n = 247), including the local adaptation of neuropsychological and behavioral assessment batteries. However, there are little to no large studies on prevalence (n = 4), biomarkers (n = 9), or neuropathology (n = 3) of FTD.Conclusions: Future FTD studies will be required in Latin America, albeit with a greater emphasis on clinical diagnosis, genetics, biomarkers, and neuropathological studies. Regional and country-level efforts should seek better estimations of the prevalence, incidence, and economic impact of FTD syndromes.
Purpose COVID-19 pandemic has multifaceted presentations with rising evidence of immune-mediated mechanisms underplay. We sought to explore the outcomes of severe COVID-19 patients treated with a multi-mechanism approach (MMA) in addition to standard-of-care (SC) versus patients who only received SC treatment. Materials and methods Data were collected retrospectively for patients admitted to the intensive care unit (ICU). This observational cohort study was performed at five institutions, 3 in the United States and 2 in Honduras. Patients were stratified for MMA vs. SC treatment during ICU stay. MMA treatment consists of widely available medications started immediately upon hospitalization. These interventions target immunomodulation, anticoagulation, viral suppression, and oxygenation. Primary outcomes included in-hospital mortality and length of stay (LOS) for the index hospitalization and were measured using logistic regression. Results Of 86 patients admitted, 65 (76%) who had severe COVID-19 were included in the study; 30 (46%) patients were in SC group, compared with 35 (54%) patients treated with MMA group. Twelve (40%) patients in the SC group died, compared with 5 (14%) in the MMA group (p-value = 0.01, Chi squared test). After adjustment for gender, age, treatment group, Q-SOFA score, the MMA group had a mean length of stay 8.15 days, when compared with SC group with 13.55 days. ICU length of stay was reduced by a mean of 5.4 days (adjusted for a mean age of 54 years, p-value 0.03) and up to 9 days (unadjusted for mean age), with no significant reduction in overall adjusted mortality rate, where the strongest predictor of mortality was the use of mechanical ventilation. Conclusion The finding that MMA decreases the average ICU length of stay by 5.4 days and up to 9 days in older patients suggests that implementation of this treatment protocol could allow a healthcare system to manage 60% more COVID-19 patients with the same number of ICU beds.
Background The impact of quarantine in older adults have been reported in several studies with contradictory results, reporting from negative effects to no significant outcomes or even beneficial consequences. Heterogeneity in aging plays a role in each region, the aim of this study is to analyze the impact of quarantine on health conditions (physical and mental) and lifestyle in older adults in five Centro American countries during COVID-19 pandemic. Method In this cross-sectional study, n = 712 older adults 60 years and older from Mexico, Guatemala, El Salvador, Honduras and Costa Rica were assessed by telephone. Sociodemographic data, physical and mental health, lifestyle and quarantine conditions were asked previous informed consent. Results In general, mean of days in quarantine at the moment of the study was 142 days (approximately four months and three weeks). In the analysis of the impact of the days in quarantine effects were found on the frequency of falls, functional ability in Activities of Daily Living (ADL), general cognitive function, memory, orientation, language, frequency of drinking alcohol, having a balanced diet, and being active cognitively. Some differences were found between countries. Conclusions Effects of quarantine on older adults in Centro America, requires attention of governments and healthcare to prevent long term morbidity and disability, and to promote healthy aging.
_____________________________________________________________________________________ Resumen:La telemedicina ha demostrado tener numerosas ventajas en la atención en salud en el mundo industrializado por su aplicación, tanto para propósitos clínicos como educativos. Existe un interés creciente en la misma por dos razones: potencial de mejorar la atención en salud y reducción de costos de dicha atención. Se ha publicado varios estudios piloto sobre las posibilidades para hacer telemedicina en Centroamérica y Latinoamérica, pero el uso de la misma es escaso. Una de las aplicaciones más utilizadas ha sido la telerradiología. Las primeras experiencias con esta metodología de atención en salud en Honduras, son prometedoras y han mostrado la viabilidad de establecer redes de telemedicina que conecten al personal de salud de zonas rurales y urbanas. La integración de la tecnología de información y comunicación a los servicios de salud podría reducir costos y dar a la población mayor acceso a atención médica especializada y subespecializada. La telemedicina es un recurso innovador y eficiente en el aspecto educativo del personal de salud mediante teleconferencias virtuales o teleconsulta subespecializada con expertos en otros países.Palabras Claves: Telemedicina; Telesalud; Consulta Remota Abstract:Telemedicine has already proven to have multiple advantages for delivering timely up-to-date health care in industrialized countries by its educational as well as clinical purposes. There is a growing interest in Telemedicine apparently related to two reasons: a potential to improve quality of health care and a reduction in its costs. There have been several pilot studies on the feasibility of telemedicine in Central America and Latin America, but the use of this technology is uncommon. One of the most used applications used is teleradiology. The first experiences that we have had in Honduras are promising and have demonstrated the viability of establishing networks of telemedicine that connect health personnel from urban and rural areas. The integration of timely information and with this new health care technology could significantly reduce costs as well as increase access to specialty and subspecialty care to a larger population. Telemedicine is an innovative and efficient tool in the education of health personnel through virtual teleconferences or subspecialty teleconsultation with experts at home or abroad.
To examine the effects of chronic malnutrition on central nervous system function, we used the somatosensory evoked potential to measure the central conduction time of 20 children aged 7-8 y with heights below the third percentile for their age and 20 control children in Honduras. The two groups differed significantly in socioeconomic status, achievement in Bender's neurointegrative test, and hematocrit, but not in birth weight. After median nerve stimulation, the mean central conduction time (interpeak latency between N13 and N20) for the growth-stunted group (6.19 +/- 0.52 ms) did not differ significantly from that of the control subjects (6.30 +/- 0.58 ms), suggesting appropriate myelination and fiber diameter. Somatosensory tracts may escape damage resulting from postnatal dietary deficiencies because myelination in these tracts is almost complete at birth.
INTRODUCTION The effects of COVID‐19 confinement have been severe, especially in older adults. Therefore, we analyzed the factors associated with cognitive impairment (CI) in Latin America (LA). METHODS We conducted a cross‐sectional observational study with a total of 5245 older adults from 10 countries in LA. Measurement We used the Telephone Montreal Cognitive Assessment (T‐MoCA) and the Eight‐item Informant Interview to Differentiate Aging and Dementia (AD8) scale. RESULTS We found that age, depressive symptomatology, bone fractures, being widowed, having a family member with dementia, and unemployment were associated with an increased risk of CI. In contrast, higher education, hypertension with continuous treatment, quarantine, and keeping stimulating cognitive and physical activities were associated with a lower probability of CI. No significant association was found between suffering from diabetes or being retired and CI. DISCUSSION It is essential to conduct follow‐up studies on these factors, considering their relationship with CI and the duration of confinement.
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