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Multilevel barriers to clinical and nutritional research in Latin America: a socioeconomic comparative analysis
(Frontiers Media SA, 2025-12-31)
Evelyn Frias-Toral
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Jaime Angamarca-Iguago
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Isabel Calvo Higuera
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Jorge Carriel-Mancilla
;
Guillermo Contreras
Clinical and nutritional research in Latin America faces significant challenges that limit scientific development and evidence-based healthcare. Understanding these barriers is essential for developing effective strategies to enhance research capacity in the region. This study aimed to identify multilevel barriers to clinical and nutritional research in Latin America and compare them between countries of different socioeconomic levels. Methods A cross-sectional study was conducted with 327 healthcare professionals involved in clinical and nutritional research across Latin America. Data collection occurred via an online survey in which participants rated the importance of 16 potential barriers on a 3-point Likert scale. Analysis included descriptive statistics, chi-square tests to compare barriers between upper-middle and lower-middle-income countries, logistic regression to identify predictors of research participation, and k-means cluster analysis to identify researcher profiles. Results Funding (84.4%), research materials (71.6%), and time constraints (70.9%) emerged as the most significant barriers across all countries. Three barriers showed statistically significant differences between income levels: participant commitment (73.6% vs. 42.6%, &lt; 0.001), frequent appointments (56.6% vs. 37.8%, = 0.02), and language barriers (39.6% vs. 22.9%, = 0.02), all of which were higher in lower-middle-income countries. Logistic regression identified the importance of research materials (OR = 0.36, = 0.002) and telemedicine (OR = 1.74,  = 0.044) as significant predictors of research participation. Cluster analysis revealed three distinct researcher profiles based on barrier perception patterns. Conclusion Multilevel barriers to research in Latin America are dominated by universal resource constraints (funding, materials, time), with lower-middle-income countries facing additional challenges in participant engagement and study logistics. The relative homogeneity of most barriers across income groups suggests that regional and institutional factors may be more influential than national income levels. These findings provide a foundation for developing targeted strategies to strengthen research capacity and infrastructure across Latin America.
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Adenomatoid odontogenic tumor in an unusual posterior maxillary location: a rare case report in a young male
(Frontiers Media SA, 2025-12-17)
GONZÁLEZ CALZADA, NATALI
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Estefanía Chávez-Mestanza
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Náthaly Mercedes Román-Galeano
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Claudia Reytor-González
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Daniel Simancas-Racines
The adenomatoid odontogenic tumor is a rare benign epithelial odontogenic neoplasm that most frequently affects young women and typically occurs in the anterior maxilla. Its presentation in the posterior maxilla, especially in male patients, is uncommon and can create diagnostic challenges. This case describes a large posterior maxillary adenomatoid odontogenic tumor in a 16-year-old male who presented with a one-year history of progressive, painless swelling of the right cheek. Clinical examination revealed facial asymmetry, obliteration of the right nasolabial fold, and intraoral swelling extending from tooth 1.5 to the posterior maxilla. Panoramic radiography and computed tomography showed a multilocular radiolucent lesion with a “soap bubble” appearance, internal calcifications, and displacement of tooth 1.8 toward the floor of the right orbit, which remained intact. The lesion caused root resorption of adjacent teeth and extensive destruction of the maxillary bone. Surgical treatment consisted of enucleation and extraction of teeth 1.5–1.8, followed by histopathological confirmation of adenomatoid odontogenic tumor. Due to the degree of bone involvement, a subsequent wide resection of critical maxillofacial structures was necessary. Postoperative follow-up at five months showed no recurrence but significant residual anatomical changes. This case emphasizes the importance of including adenomatoid odontogenic tumor in the differential diagnosis of posterior maxillary lesions in male patients, and the need for careful surgical planning, histopathological confirmation, and long-term follow-up.
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Available evidence on integrating COVID-19 into sentinel surveillance systems: A scoping review
(Medwave Estudios Limitada, 2025-10-20)
Jorge Gualotuña-Suntaxi
;
Diana Pérez-Muñoz
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Raynier Zambrano-Villacres
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ZAMBRANO ESPINOSA, ANA KARINA
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Daniel Simancas-Racines
Introduction The COVID-19 pandemic exposed the weaknesses of epidemiological surveillance systems and highlighted the need to integrate new respiratory viruses into sentinel surveillance systems. However, current evidence on their effectiveness remains limited. Aim This project conducts a scoping review to describe the available evidence on the integration of COVID-19 into sentinel surveillance systems. Methods The included studies addressed sentinel surveillance in the context of the pandemic following the World Health Organization declaration. A systematic search was performed in databases including MEDLINE, LILACS, EPISTEMONIKOS, and DIMENSIONS, selecting observational studies and systematic reviews. Data collection and analysis were organized into categories such as clinical characteristics, timely detection, geographic representativeness, co-infection, and adaptability with genomic surveillance. Seventeen studies reporting on COVID-19 integration impact and one preliminary WHO report were identified. Results Results identified the most prevalent symptoms in the general population: fever (73%), cough (51.8%), loss of taste or smell (45.1%), hypoxemia (33%), and sputum production (23.9%). A high correlation was obtained between SARI cases or hospitalizations due to respiratory infection and the incidence of COVID-19 (ρ = 0.78 and ρ = 0.82 respectively). Conclusions Integrating COVID-19 into the sentinel surveillance system could improve detection, response, and follow-up capacity. Additionally, implementing standardized case definitions promotes more efficient use of laboratory resources, thereby enhancing the sustainability of the surveillance system.
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Climate Change and health: vulnerability pathways and resilience policies
(Medwave Estudios Limitada, 2025-10-27)
IZURIETA GUEVARA, MÓNICA GIOCONDA
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Juan Marcos Parise-Vasco
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LALANGUI VIVANCO, KARINA DEL ROCÍO
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Daniel Simancas-Racines
Climate change is a serious threat to public health. The intensity and devastation of 21st-century climate events exacerbate the vulnerability of certain social groups that already face historical disadvantages. The objective of this article is to examine various dimensions of health vulnerability in the context of anthropogenic climate change. A narrative review was conducted based on articles published in the last five years from the Scopus, Medline/PubMed, LILACS databases, and an intentional search of current publications by international organizations and commissions focused on the topic. The review identified and characterized four types of health vulnerability dimensions: social, economic, geographic, and health infrastructure; it also presents multiple intersectionalities that converge at the interface of climate change and health which increase the risk of physical and mental illnesses. Based on the proposed discussion, public policy guidelines are suggested for resilient health systems and effective information structures for timely decision-making.

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