Background: Diagnosis and treatment of systemic lupus erythematosus (SLE) are often delayed in Latin America due to barriers at the patient, provider, and health care system levels. Methods: This qualitative study, conducted in 16 countries, explored the experiences and recommendations of persons with SLE and rheumatologists to identify key needs and strategies to improve care. Semistructured interviews and focus groups were analyzed thematically. Results: Six main themes emerged: (1) education and training, (2) access to specialized care, (3) health care system organization, (4) awareness, (5) patient organizations, and (6) research. Participants underscored the need to strengthen professional competencies, decentralize care, reduce administrative barriers, and raise awareness among decision-makers and society. Conclusions: The perspectives of persons with SLE and rheumatologists converge on the urgent need for coordinated, equitable, and patient- and caregiver-centered approaches to SLE care. Implementing these recommendations—through improved education, health care system reform, advocacy, and research—could substantially reduce diagnostic and treatment delays and improve outcomes for people living with SLE in Latin America.
El trastorno del espectro autista (TEA) es una condición del neurodesarrollo cuya prevalencia se ha incrementado significativamente la última década. Objetivo: Describir las características sociodemográficas, clínicas y educativas de los niños con TEA atendidos en el servicio de psicología de un hospital nacional de Lima, Perú, en 2024. Materiales y métodos: Se realizó un estudio descriptivo y retrospectivo basado en la revisión de historias clínicas electrónicas. Se analizaron datos de 420 niños, considerando edad, sexo, procedencia, composición familiar, escolaridad, diagnóstico CIE-10, comorbilidades, tratamientos y resultados de evaluaciones estandarizadas de funcionamiento intelectual y conducta adaptativa. Se empleó estadística descriptiva para el análisis de los datos. Resultados: El 84,8 % de la muestra correspondió al sexo masculino. El diagnóstico más registrado fue el autismo infantil (F84.0). La mayoría de los participantes vivía con ambos padres, era paciente continuador y asistía a educación básica regular. Un tercio presentó comorbilidades, principalmente trastorno por déficit de atención e hiperactividad (70,9 %). El 9 % recibía tratamiento farmacológico y dos tercios asistían a terapias no farmacológicas. Los niveles intelectuales y adaptativos se ubicaron mayormente en rangos bajos. Conclusiones: Los hallazgos revelan un predominio del sexo masculino, una alta frecuencia de comorbilidades y una limitada cobertura de evaluaciones estandarizadas. Se evidencia la necesidad de fortalecer los procesos diagnósticos, ampliar el acceso a evaluaciones interdisciplinarias y optimizar el uso de la historia clínica electrónica en el sistema de salud público peruano.
BACKGROUND:Although adult T-cell leukemia/lymphoma (ATL) has a higher burden in Latin America compared to North American or European countries, few studies have described the outcomes of this disease. We estimated the hospital-based prevalence and overall survival (OS) of ATL. METHODS:We conducted a cohort study among patients aged ≥ 18 years with pathologically diagnosed mature T-cell lymphoma across 11 Latin American countries from 2000 to 2023 by pooling data from 3 hospital-based registries. We used the Kaplan-Meier method to estimate survival outcomes. RESULTS:Among 1963 patients with mature T-cell lymphoma, the pooled prevalence of ATL was 17 % (n = 329; 95 % confidence interval [CI]=15-18 %), with the highest observed in Peru (n = 158; 38 %, 95 % CI=33-43 %) and Colombia (n = 17; 29 %, 95 % CI=18-41 %). Over time, ATL cases only increased significantly in Peru, from 14 % in 2000-2004 to 58 % in 2019-2023 (Ptrend<0.001). With a median follow-up of 37 months (95 % CI=30-54 months), the 3-year OS of ATL was 25 % (95 % CI=20-32 %), and the median OS was 9 months (95 % CI=8-12 months). OS did not differ across countries (range 19-47 %, P = 0.210). Patients with lymphomatous ATL had worse outcomes than those with PTCL-NOS only in Peru (Pheterogeneity=0.029). CONCLUSION:Our findings indicate a higher ATL prevalence in Latin America than previously reported in North America or Europe, likely due to differences in HTLV-1 endemicity and diagnostic practices. The similar and poor survival rates across countries underscore the need for targeted interventions to improve patient outcomes. We propose expert-based research priorities and suggest further epidemiological validation studies.
Gestational trophoblastic tumours are neoplasms that derive from trophoblastic tissue; therefore, their occurrence is generally intrauterine. We report the case of a 27-year-old woman with an ovarian tumour that arose during pregnancy. The patient did not have postpartum checkups and came to the clinic after eighteen months, presenting multiple lymphadenopathy predominantly in the cervical region, one of which was biopsied. In the microscopic study, the presence of syncytiotrophoblast-like cells supported the diagnosis of a metastasis of gestational trophoblastic neoplasia. The serum levels of bHCG were found to be elevated. Tomographic and ultrasound images did not show any uterine tumour. Immunohistochemistry allowed us to establish the diagnosis of placental site trophoblastic tumour metastasis.
