Browsing by Author "Duque, Lissette"
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Publication Biomarkers for dementia in Latin American countries: Gaps andopportunities(2023) Parra, Mario A.; Orellana, Paulina; León, Tomas; Victoria, Cabello G.; Henriquez, Fernando; Gomez, Rodrigo; Avalos, Constanza; Damian, Andres; Slachevsky Chonchol, Andrea; Ibañez, Agustin; Zetterberg, Henrik; Tijms, Betty M.; Yokoyama, Jennifer S.; Piña-Escudero, Stefanie D.; Cochran, Nicholas; Matallana, Diana L.; Acosta, Daisy; Allegri, Ricardo; Arias-Suáres, Bianca P.; Barra, Bernardo; Behrens, María Isabel; Brucki, Sonia M.D.; Busatto, Geraldo; Caramelli, Paulo; Castro-Suarez, Sheila; Contreras, Valeria; Custodio, Nilton; Dansilio, Sergio; De la Cruz-Puebla, Myriam; Cruz de Souza, Leonado; Díaz, Monica M.; Duque, Lissette; Farias, Gonzalo A.; Ferreira, Sergio T.; Magrath Guimet, Nahuel; Kmaid, Ana; Lira, David; Lopera, Francisco; Mar Meza, Beatriz; Miotto, Eliane C.Limited knowledge on dementia biomarkers in Latin American and Caribbean (LAC)countries remains a serious barrier. Here, we reported a survey to explore the ongo-ing work, needs, interests, potential barriers, and opportunities for future studiesrelated to biomarkers. The results show that neuroimaging is the most used biomarker(73%), followed by genetic studies (40%), peripheral fluids biomarkers (31%), and cere-brospinal fluid biomarkers (29%). Regarding barriers in LAC, lack of funding appears toundermine the implementation of biomarkers in clinical or research settings, followedby insufficient infrastructure and training. The survey revealed that despite the abovebarriers, the region holds a great potential to advance dementia biomarkers research.Considering the unique contributions that LAC could make to this growing field,we highlight the urgent need to expand biomarker research. These insights allowedus to propose an action plan that addresses the recommendations for a biomarkerframework recently proposed by regional experts.Item Systematic Review of the Diagnostic Validity of Brief Cognitive Screenings for Early Dementia Detection in Spanish-Speaking Adults in Latin America(2020) Custodio, Nilton; Duque, Lissette; Montesinos, Rosa; Alva-Díaz, Carlos; Mellado, Martin; Slachevsky, AndreaObjectives: The aim of this study was to evaluate the validity of brief cognitive screening (BCS) tools designed to diagnose mild cognitive impairment (MCI) or dementia in Spanish-speaking individuals over the age of 50 years from Latin America (LA). Methods: A systematic search of titles and abstracts in Medline, Biomed Central, Embase, Scopus, Scirus, PsycINFO, LILACS, and SciELO was conducted. Inclusion criteria were papers written in English or Spanish involving samples from Spanish-speaking Latin American individuals published until 2018. Standard procedures were applied for reviewing the literature. The data related to the study sample, methodology, and procedures applied, as well as the performance obtained with the corresponding BCS, were collected and systematized. Results: Thirteen of 211 articles met the inclusion criteria. The studies primarily involved memory clinic-based samples, with the exception of two studies from an adult day-care center, one from a primary care clinic, and one from a community-based sample. All the studies originated from five of the 20 countries of LA and all used standardized diagnostic criteria for the diagnosis of dementia and MCI; however, the diagnostic protocols applied differed. Most studies reported samples with an average of 10 years of education and only one reported a sample with an average of <5 years of education. No publication to date has included an illiterate population. Although the Montreal cognitive assessment (MoCA) is the most widely-used BCS tool in LA, it is significantly influenced by education level. Conclusions: Although evidence is still limited, the findings from studies on LA populations suggest that MoCA requires cultural adaptations and different cutoff points according to education level. Moreover, the diagnostic validity of the INECO frontal screening (IFS) test should be evaluated in populations with a low level of education. Given the heterogeneity that exists in the levels of education in LA, more studies involving illiterate and indigenous populations are required.Item Un llamado ético a la inclusión de mujeres embarazadas en investigación: Reflexiones del Foro Global de Bioética en Investigación(Pan American Health Organization, 2017) Saenz, Carla; Alger, Jackeline; Beca, Juan Pablo; Belizan, Jose; Cafferata, Maria Luisa; Canario Guzman, Julio Arturo; Candanedo, Jesica; Duque, Lissette; Figueroa, Lester; Garces, Ana; Gresh, Lionel; Gubert, Ida Cristina; Guilhem, Dirce; Guz, Gabriela; Kaltwasser, Gustavo; Lescano, Roxana; Luna, Florencia; Cardelli, Alexandrina; Mastroleo, Ignacio; Melamed, Irene; Muñoz del Carpio Toia, Agueda; Palacios, Ricardo; Palma, Gloria; Salas Ibarra, Sofía; Sandoval, Xochitl; Surugi de Siqueira, Sergio; Vasquez, Hans; Villela de Vega, BerthaThe Global Forum on Bioethics in Research (GFBR) met on November 3 and 4 in Buenos Aires, Argentina with the purpose of discussing the ethics of research with pregnant women. The GBRF is a global platform that brings together key actors with the purpose of promoting research conducted in an ethical way, strengthening health research ethics–particularly in low- and medium-income countries–and promoting collaboration between the countries in the north and the south.a Some of the participants of the GFBR attending from Latin America include ethicists, researchers, ethics committee members and representatives of health authorities from Argentina, Brazil, Chile, Colombia, Ecuador, El Salvador, Guatemala, Honduras, Panama, Peru, Nicaragua and Dominican Republic. A legitimate concern about the protection of pregnant women and their embryos or fetuses has led most of the countries in the region to restrict studies with pregnant women exclusively to those that are about pregnancy, and to require the systematic exclusion of pregnant women and women who get pregnant from the rest of studies. Certainly, throughout the history of research ethics it has been mistakenly believed that protecting a population is synonymous with excluding that population from studies. It is now known that proceeding in this way implies exposing the very population we want to protect to larger risks. Pregnancy implies substantial physiological changes that significantly influence the way the body metabolizes medications. However, by avoiding conducting research with pregnant women, the necessary scientific evidence to inform decisions on preventive treatments and interventions with effective and safe dosage for them and their embryos or fetuses has not been produced. As an illustration, in 2001 there were barely a dozen medications approved for use during pregnancy in the United States1 , and in 2011 the Food and Drug Administration (FDA) approved, for the first time in 15 years, a medication to be used during pregnancy.2 As a result, pregnant women’s health is jeopardized every time we provide them health care. Pregnant women get sick and sick women get pregnant, and it is not known if the medications they are prescribed are efficacious or even safe for them and their embryos or fetuses.