PURPOSE: Project Strengthening Emergency Medicine, Investing in Learners in Latin America (SEMILLA) created a novel, language and resource appropriate course for the resuscitation of cardiac arrest for Nicaraguan resident physicians. We hypothesized that participation in the Project SEMILLA resuscitation program would significantly improve the physician's management of simulated code scenarios. METHODS: Thirteen Nicaraguan resident physicians were evaluated while managing simulated cardiac arrest scenarios before, immediately, and at 6 months after participating in the Project SEMILLA resuscitation program. This project was completed in 2014 in Leon, Nicaragua. The Cardiac Arrest Simulation Test (CASTest), a validated scoring system, was used to evaluate performance on a standardized simulated cardiac arrest scenario. Mixed effect logistic regression models were constructed to assess outcomes. RESULTS: On the pre-course simulation exam, only 7.7% of subjects passed the test. Immediately post-course, the subjects achieved a 30.8% pass rate and at 6 months after the course, the pass rate was 46.2%. Compared with pre-test scores, the odds of passing the CASTest at 6 months after the course were 21.7 times higher (95% CI 4.2 to 112.8, P<0.001). Statistically significant improvement was also seen on the number of critical items completed (OR=3.75, 95% CI 2.71-5.19), total items completed (OR=4.55, 95% CI 3.4-6.11), and number of "excellent" scores on a Likert scale (OR=2.66, 95% CI 1.85-3.81). CONCLUSIONS: Nicaraguan resident physicians demonstrate improved ability to manage simulated cardiac arrest scenarios after participation in the Project SEMILLA resuscitation course and retain these skills.
Curriculum* ; Emergency Medicine ; Heart Arrest* ; Latin America ; Logistic Models ; Nicaragua ; Resuscitation*

OBJECTIVES: The purpose of this study was to describe the source, length, number of views, and content of the most widely viewed Zika virus (ZIKV)-related YouTube videos. We hypothesized that ZIKV-related videos uploaded by different sources contained different content. METHODS: The 100 most viewed English ZIKV-related videos were manually coded and analyzed statistically. RESULTS: Among the 100 videos, there were 43 consumer-generated videos, 38 Internet-based news videos, 15 TV-based news videos, and 4 professional videos. Internet news sources captured over two-thirds of the total of 8 894 505 views. Compared with consumer-generated videos, Internet-based news videos were more likely to mention the impact of ZIKV on babies (odds ratio [OR], 6.25; 95% confidence interval [CI], 1.64 to 23.76), the number of cases in Latin America (OR, 5.63; 95% CI, 1.47 to 21.52); and ZIKV in Africa (OR, 2.56; 95% CI, 1.04 to 6.31). Compared with consumer-generated videos, TV-based news videos were more likely to express anxiety or fear of catching ZIKV (OR, 6.67; 95% CI, 1.36 to 32.70); to highlight fear of ZIKV among members of the public (OR, 7.45; 95% CI, 1.20 to 46.16); and to discuss avoiding pregnancy (OR, 3.88; 95% CI, 1.13 to 13.25). CONCLUSIONS: Public health agencies should establish a larger presence on YouTube to reach more people with evidence-based information about ZIKV.
Africa ; Anxiety ; Health Communication ; Internet ; Latin America ; Pregnancy ; Public Health ; Social Media ; Zika Virus*

Myiasis is a parasitic infestation of vertebrate animal tissues due to maggots of two-winged flies (Diptera) that feed on living or necrotic tissue. Dermatobia hominis occurs widely in tropical parts of Latin America; it is the most common cause of furuncular myiasis in this region. The continuous increase in international travel has increased the possibility of observing this pathology outside endemic countries, especially in travelers returning from the tropics. If clinicians are aware of the possibility of the disease and its treatment options, this dermatosis can be easily managed. However, diagnostic delay is very common because the disease is often misdiagnosed as a bacterial skin infection. Here, we report 2 cases of furuncular myiasis caused by D. hominis in travelers returning to Italy from Latin America. Surgical and noninvasive treatment approaches are also described.
Animals ; Diptera ; Humans ; Italy ; Larva ; Latin America ; Myiasis ; Pathology ; Skin Diseases ; Skin* ; Transients and Migrants* ; Vertebrates

The Environmental Health Program of the Pan American Health Organization has established goals to be able to comply with the resolutions of the Board of Directors and the Executive Committee. As an integral part of the Environmental Health Program, the Pan American Center for Human Ecology and Health (ECO) must contribute to the achievement of these goals. Generally speaking, there is a scarcity of toxicology professionals in the Region of the Americas. In order to ameliorate this situation, it is suggested that activities in the areas of training professionals, conducting research, dissemination of information, and publishing of educational materials be undertaken. It is proposed that the "Joint Toxicology Network at the Regional Level" be created. The objectives of such a network would be the promotion and encouragement of activities in the area of toxicology; assistance to countries in identifying their needs; encouragement of information exchange, publication and training in toxicology; and support of the Toxicology Information Centers. In order to achieve the Network objectives, it is suggested that activities be undertaken by the national groups belonging to the network.
Environmental Health ; International Cooperation ; Latin America ; Pan American Health Organization ; organization & administration ; Toxicology ; organization & administration

PURPOSE: NTM(non tuberculous mycobacteria) is rare cause of surgical site infection after plastic surgery in immunocompetent patients. There are some reports about NTM infection after body contouring procedure from Latin America. But, there is no report in Korea. The purpose of this article is to report 2 patients with soft tissue infection caused by NTM after body contouring procedure. METHODS: Two young female patients exhibited signs of inflammation and abscess after body contouring procedure. One patient underwent liposuction. The other underwent HPL(hypotonic pharmacologic lipo-dissolution) injection. RESULTS: The result of tissue cultures were positive for NTM. All patients responded to the combined therapeutic approach. CONCLUSION: The goal of this article is to raise awareness among plastic surgeons who may encounter such patients in their practice. NTM should be included in the differential diagnosis of surgical site infection after body contouring surgery.
Abscess ; Diagnosis, Differential ; Female ; Humans ; Inflammation ; Korea ; Latin America ; Lipectomy ; Nontuberculous Mycobacteria ; Soft Tissue Infections ; Surgery, Plastic

Brucellosis is a systemic, infectious disease caused by the bacterial genus Brucella and a common zoonosis that still remains a major health problem in certain parts of the world such as the Mediterranean region, the Middle East, and Latin America. It may involve multiple organs and tissues. Osteoarticular involvement is the most frequent complication of brucellosis, in which the diagnosis of brucellar spondylitis is often difficult since the clinical presentation may be obscured by many other conditions. There are only a few reports on brucellar spondylitis in Korea. Here, we report a case of spondylitis due to brucella in an elderly male.
Aged ; Back Pain ; Brucella ; Brucellosis ; Communicable Diseases ; Humans ; Korea ; Latin America ; Lumbosacral Region ; Male ; Mediterranean Region ; Middle East ; Spondylitis

Tungiasis is an ectoparasitic disease that is caused by the penetration of Tunga penetrans into the epidermis of the host. Tungiasis is indigenous to South Americaand the Caribbean regions, but it has spread to Latin America, India, and sub-Saharan Africa. The area of soft skin such as the soles, toes, webs and subungual regions are the favored sites for sand flea embedding. As the flea enlarges within epidermis a pruritic, painful white or erythematous papulonodule develops. A black central punctum is characteristic. A 32-year-old woman presented with a small black crust on the right sole after traveling to an endemic area(Congo). Histopathologic examination revealed the internal organs of the arthropod embedded intothe epidermis, which allowed a definitive diagnosis of tungiasis. Although tungiasis is common in endemic areas, there has been no report of tungiasis in the Korean literature. We report herein an interesting case of tungiasis in a patient after traveling to Congo.
Adult ; Africa South of the Sahara ; Arthropods ; Caribbean Region ; Congo ; Epidermis ; Female ; Humans ; India ; Latin America ; Siphonaptera ; Skin ; Toes ; Tunga ; Tungiasis

BACKGROUND: Hypertrophic cardiomyopathy (HCM) is the most common hereditary heart disease with diverse phenotipyc, genetic expession and clinical presentations. The evolution of patients with HCM in Latin America has not been properly described being the frequency, the long-term prognosis as well as the predominant phenotypic expression still unknown. The aim of this study was to determine the survival rate of HCM patients having different phenotypes in a Mexican cohort of patients. METHODS: Clinical and echocardiographic data obtained from 77 Mexican patients with recently diagnosed HCM were analyzed. The follow-up was of 12.5 years. RESULTS: 96.1% of patients were in functional class I/II according to the New York Heart Association, 2.6% in class III and 1.3% in class IV. Only 3.9% of them went to surgery for myectomy. During the follow-up, 17 patients (22%) died: 4/9 (44%) had apical HCM, 5/20 (25%) had obstructive septal asymmetric HCM, 6/35 (17%) had nonobstructive septal asymmetric HCM and 2/3 (15%) had concentric HCM. The survival rate was worse for patients with apical HCM, followed by those with obstructive and nonobstructive septal asymmetric HCM and patients showing concentric HCM had the best survival rates. There is significant difference in survival rates which declined in 65% in a 9 years-period. Log rank test showed significant differences (p < 0.002). CONCLUSION: The survival rate of patients with HCM was worse in those with apical variety. The majority of patients received medical treatment. The indication for myectomy was below that observed in other international centers.
Cardiomyopathy, Hypertrophic* ; Cohort Studies* ; Echocardiography ; Follow-Up Studies ; Heart ; Heart Diseases ; Humans ; Latin America ; Phenotype ; Prognosis ; Survival Rate

OBJECTIVES: Zika virus currently poses a global threat and is a major public health issue throughout Latin America and the Caribbean. However, Zika virus infections in humans have also been observed in other regions, including Southeast Asia, where arboviral diseases are very common. In this study, we summarize the current status of Zika virus in Southeast Asia. This review aims to provide an overview of the current situation and also to suggest ways of adequately managing the emergence of Zika virus in Southeast Asia. METHODS: The literature searching for the reports on Zika virus in Southeast Asia was done using standard database PubMed and the re-analysis and summarization on the reports was done. RESULTS: A limited number of reports have addressed Zika virus disease in Southeast Asia, but it is has been confirmed that a problem already exists. Individual case reports and outbreaks of Zika virus have been confirmed in Southeast Asia. Several reports have also described patients becoming infected after visiting Southeast Asia. In addition, the concurrent circulation of Zika virus with other arboviruses has been confirmed. CONCLUSIONS: As a tropical region with a high prevalence of arboviral diseases, the emergence of Zika virus in Southeast Asia is a major concern. It is essential for local medical personnel to recognize this disease. Given the status of Southeast Asia as a globally important tourist destination, continuous updates on the status of Zika virus in Southeast Asia are required and should be incorporated into global health advisories regarding travel.
Arboviruses ; Asia, Southeastern* ; Caribbean Region ; Disease Outbreaks ; Global Health ; Humans ; Latin America ; Prevalence ; Public Health ; Zika Virus Infection ; Zika Virus*

Zika is a re-emerging, mosquito-borne viral infection, which has been recently shown to cause microcephaly and Guillain-Barré syndrome. Since 2015 the number of infected patients has increased significantly in South America. The purpose of this study was to identify the epidemiologic and clinical characteristics of patients with Zika virus (ZIKV) infections in Korea. Patients who had visited areas of risk and tested positive in the ZIKV reverse transcriptase polymerase chain reaction (RT-PCR) in blood, urine, or saliva specimens were included. The first Korean case of ZIKV infection was reported in March 2016, and 14 cases had been reported by October 2016. The median age of the patients was 34 years (19–64 years). Ten patients had been exposed in Southeast Asia and 4 in Latin America. Rash was the most common symptom (92.9%; 13/14), followed by myalgia (50.0%; 7/14), and arthralgia (28.6%, 4/14). There were no neurologic abnormalities and none of the patients was pregnant. Results of biochemical tests were normal. Positivity rates of RT-PCR for ZIKV in serum, urine, and saliva were 53.8%, 100.0%, and 83.3%, respectively in the first week of symptoms. In conclusion, 14 patients with ZIKV infections were reported in Korea by October 2016 and all of them had mild clinical symptoms.
Arthralgia ; Asia, Southeastern ; Epidemiology* ; Exanthema ; Guillain-Barre Syndrome ; Humans ; Korea* ; Latin America ; Microcephaly ; Myalgia ; Reverse Transcriptase Polymerase Chain Reaction ; Saliva ; South America ; Virus Shedding ; Zika Virus*