RESUMO

Liver disease poses a substantial burden in Latin America. This burden is primarily attributed to a high level of alcohol consumption and the increasing prevalence of risk factors associated with metabolic dysfunction-associated steatotic liver disease (MASLD), such as sedentary lifestyles, easy access to ultra-processed foods, obesity, and type 2 diabetes mellitus. These epidemiological trends are cause for concern, especially considering that there are significant challenges in addressing them, due to disparities in access to liver disease screening and care. In this article, we aim to provide an overview of the current situation regarding liver disease in Latin America. We also discuss recent multinational proposals designed to address the growing MASLD burden via its integration into existing non-communicable diseases policies, at both local and global levels. Additionally, we emphasize the urgent need to establish effective public health policies that target both MASLD risk factors and excessive alcohol consumption. Furthermore, we discuss the development of liver transplantation programs, areas for improvement in medical education and research capabilities, and how the fostering of extensive collaboration among all stakeholders is crucial for addressing liver disease in the region.

RESUMO

In Chile, overnutrition continues to increase, especially affecting children. Solving this public health problem requires the development of promotion and prevention strategies that consider the suggestions of the communities, especially those of the children themselves. OBJECTIVE: To know the opinions and suggestions of third and fourth-grade children from schools in the southern area of Santiago, Chile, regarding their eating practices and physical activity, as part of the FONDEF IT 1810016 project. SUBJECTS AND METHOD: Seven School Meetings were held in seven schools using a participatory qualitative methodology, collecting the opinions of 176 children regarding both their food and physical activity habits and preferences. RESULTS: The most consumed and preferred foods are those easy to prepare and highly available, such as bread, pasta, and milk. Foods that require preparation or are less available, such as fish, legumes, fruits, vegetables, and homemade preparations, are less consumed and have less preference. Regarding physical activities, video games and soccer stand out. Students propose increasing the hours of physical education and recesses and improving the availability and access to healthy foods in school environments as a solution strategy. CONCLUSIONS: School Meetings as a participatory strategy contribute to the joint generation of knowledge. The need to include communities as participants in health initiatives recognizes, through their role, children as subjects of rights.

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In Chile, the Immunization Department of the Ministry of Health has carried out the seasonal influenza vaccination campaign annually since 1982 in collaboration with the national health services, regional health offices, and primary health care centres. With the aim of preventing deaths and serious morbidity in high-risk groups and preserving the integrity of health services, the seasonal influenza campaign had been the largest implemented in Chile until 2020, since in 2021 the vaccination campaign against SARS-CoV-2 is expected to become the largest ever implemented. In response to local demographic and epidemiological changes, and taking into account the new scientific evidence on the safety and immunogenicity of vaccines, the influenza vaccines available in Chile would increase annually as a result of campaign planning. In 2020, the influenza campaign had to be re-planned while in progress due to the addition of new high-risk groups to be vaccinated in accordance with the SARS-CoV-2 pandemic health alert modification of March 6th, 2020. Over the course of three weeks, the Immunization Department managed to increase the doses of available influenza vaccines from 6,799,800 previously agreed upon to 8,480,325 and thus serve high-risk groups, guaranteeing their access to state funded influenza vaccination.

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Resumen Desde 1982, cada año el Departamento de Inmunizaciones del Ministerio de Salud de Chile lleva a cabo la campaña de vacunación contra influenza junto con las Secretarías Regionales Ministeriales-SEREMI, Servicios de Salud y centros de atención primaria de salud. Con los objetivos de prevenir mortalidad y morbilidad grave en grupos de mayor riesgo y de preservar la integridad de los servicios de salud, hasta el 2020 las campañas de vacunación contra influenza serían las más grandes implementadas en Chile, para dar paso, el 2021, a la vacunación contra SARS-CoV-2. Obedeciendo a cambios demográficos y epidemiológicos locales y acogiendo los avances científicos sobre seguridad e inmunogenicidad de la vacuna, el incremento de las vacunas influenza disponibles en Chile forma parte de la planificación anual de la campaña. El 2020, sin embargo, la Campaña Influenza tuvo que ser re-planificada en curso como consecuencia de la incorporación de nuevos grupos a vacunar según dispuso la modificación de la alerta sanitaria por brote de SARS-CoV-2 del 6 de marzo de 2020. Así, de 6.799.800 de dosis, el Departamento de Inmunizaciones logró en menos de dos meses aumentar la disponibilidad a 8.480.325, y cumplir con el compromiso de garantizar el acceso de los grupos de riesgo al beneficio de la vacunación estatal gratuita.

Abstract In Chile, the Immunization Department of the Ministry of Health has carried out the seasonal influenza vaccination campaign annually since 1982 in collaboration with the national health services, regional health offices, and primary health care centres. With the aim of preventing deaths and serious morbidity in high-risk groups and preserving the integrity of health services, the seasonal influenza campaign had been the largest implemented in Chile until 2020, since in 2021 the vaccination campaign against SARS-CoV-2 is expected to become the largest ever implemented. In response to local demographic and epidemiological changes, and taking into account the new scientific evidence on the safety and immunogenicity of vaccines, the influenza vaccines available in Chile would increase annually as a result of campaign planning. In 2020, the influenza campaign had to be re-planned while in progress due to the addition of new high-risk groups to be vaccinated in accordance with the SARS-CoV-2 pandemic health alert modification of March 6th, 2020. Over the course of three weeks, the Immunization Department managed to increase the doses of available influenza vaccines from 6,799,800 previously agreed upon to 8,480,325 and thus serve high-risk groups, guaranteeing their access to state funded influenza vaccination.

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Não existe cinsenso na definição de epilepsia catastrófica. Neste artigo, designamos como tal as epilepsias resistentes a todas terapêuticas disponíveis e que alteram severamente a organização e a economia familiar. Foram analisadas 10 crianças com epilepsias resistentes (4 ou mais crises/mes) a tratamento clínico ou cirúrgico (conceito biológico), onde foi calculado o custo direto (conceito econômico). Foi utilizado o dicionário da Real Academia Espanhola que designa como catástrofe, evento indesejável que altera a ordem regular dos fatos. Mediante a prova de Hoare y Alvarez foi construído um conceito psicolingúístico, onde foi assimilado um custo intangível. As crianças tinham em média 5.4 anos de epilepsia refratária e toda terapia disponível e foram observados em média por 5 anos. A maioria dos pacientes tinha epilepsia parcial sistomática resistente, dois foram operados sem êxito e o custo direto para o grupo de US$ 4032. Todas as crianças pertenciam a classe socioeconômica desfavorável. Na maioria, o pai tinha baixa escolaridade e a metade deles eram desempregados. A doença gerou um severo impacto na qualidade de vida da criança e da família. A característica comum de todas as crianças é que possuíam epilepsias resistentes a todo tratamento disponível, de alto custo direto e que alterava severamente a estrutura familiar

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