Universidad Latina

Yellow fever (YF) remains a major public health concern in Latin America. We characterise the early-2025 outbreak, compare it with prior waves-especially Southeast Brazil (2016-2018)-and examine environmental, structural, and policy-related drivers. We reviewed regional surveillance data and mortality records from January to April 2025, comparing them to historical outbreak data. Case fatality rate (CFR), geographic spread, and population vulnerability patterns were analyzed. We also reviewed published literature and health alerts to contextualize contributing factors. In 2025, 301 confirmed cases and 124 deaths were reported (CFR 41.1%), mostly in Bolivia, Brazil, Colombia, and Peru, concentrated among unvaccinated populations at the forest-urban interface. Transmission remains sylvatic, but peri-urban spillover risk is rising. Deforestation, climate variability, cross-border migration, and political instability heighten vulnerability; surveillance is fragmented and vaccine uptake insufficient in high-risk groups. YF is re-emerging through intertwined biological, ecological, and socio-political forces. Preventing another large-scale epidemic requires strengthened, integrated surveillance, including Non-Human Primates (NHP) epizootics, equity-centred immunisation in remote areas, and coordinated regional action focused on prevention, early detection, and health-system resilience.

Fungal empyema thoracis is a rare but highly morbid pleural infection, most commonly caused by Candida species and associated with high mortality. Diagnosis is challenging, particularly in polymicrobial infections, where fungal pathogens may initially remain unrecognized. Broad-spectrum antibiotic use may facilitate fungal overgrowth and delay diagnosis. A 79-year-old man with chronic kidney disease, prior laryngectomy with permanent tracheostomy, and a history of malignancy presented with community-acquired pneumonia and parapneumonic effusion. Initial treatment with broad-spectrum antibiotics resulted in transient improvement. However, the patient subsequently deteriorated, with imaging demonstrating rapid progression to a loculated empyema with air-fluid levels. Pleural drainage yielded purulent fluid, with negative bacterial cultures. Candida glabrata was later isolated from pleural fluid. Antibacterial therapy was discontinued, and antifungal treatment with micafungin, combined with pleural drainage, led to clinical and radiological improvement. This case suggests early fungal involvement within a polymicrobial pleural infection, with subsequent fungal predominance following antibacterial therapy. The rapid progression observed contrasts with the typically indolent course of fungal empyema and highlights the importance of considering fungal etiologies in patients who fail to respond to antibiotics. Fungal empyema should be suspected in patients with persistent or worsening pleural infection despite appropriate antibacterial therapy. Early recognition and combined antifungal therapy with adequate drainage are essential to improve outcomes.

For techniques teaching, pre-registration, statistical software validation, pilot testing, and privacy-preserving analytical prototyping, synthetic datasets are becoming more and more crucial in health research. Nevertheless, current tools are still disjointed, often depend on platform-specific implementations, and seldom integrate statistical validation with a uniform specification language. In order to create, verify, and export synthetic datasets for various quantitative research designs in the health sciences, this paper introduces GENERA-BASE, a specification-driven and method-agnostic framework. Four steps comprise the framework: method-agnostic data production, integrated validation via seven kinds of statistical integrity tests, cross-platform export to SPSS, R, Python, Stata, SAS, and JASP, and structured definition of research design and goal statistical attributes. Four popular design patterns in health research-an experimental randomized controlled trial-like design, a correlational/regression design, a longitudinal cohort, and a Likert-based psychometric structure-were used to assess the framework's effectiveness. One calibration cycle was sufficient to retrieve all 44 predetermined validation indications across the four applications within tolerance. The longitudinal dataset replicated the target monthly slope, the correlational dataset recovered the expected association structure, the psychometric dataset attained acceptable reliability and factor-related properties, and the synthetic randomized trial replicated the target intervention effect with preserved baseline equivalency. Overall fidelity was very good across 18 numerical target-versus-achieved metrics (Pearson r = 0.9985, p < 0.001). These results suggest that GENERA-BASE offers a transparent, interoperable, and repeatable system for creating synthetic data in health research. Its primary contribution is to help training, methodological experimentation, pilot preparation, and pre-registered analytical research by combining structured specification, validation, and platform interoperability into a unified methodical process.

Infantile colic is one of the most common functional gastrointestinal disorders, affecting approximately 20% of infants worldwide. Characterized by paroxysmal episodes of inconsolable crying and fussing without an obvious cause, the condition imposes a significant psychosocial burden on the family unit, acting as a primary trigger for maternal postpartum depression, parental exhaustion, and premature cessation of breastfeeding. Despite its prevalence, traditional management in primary care remains heterogeneous and often ineffective, leaving a substantial therapeutic gap. Emerging research has identified gut dysbiosis as a cornerstone of its pathogenesis, where an imbalance in early microbial colonization, characterized by reduced diversity and a higher prevalence of gas-producing coliforms, triggers intestinal inflammation and visceral hypersensitivity through the gut-brain axis. This narrative review synthesizes the current clinical evidence regarding the efficacy and safety of Limosilactobacillus reuteri DSM 17938 in the management of infantile colic. This specific probiotic strain exerts its therapeutic effects through multifaceted mechanisms, including the production of the antimicrobial metabolite reuterin, the modulation of gastrointestinal motility via microvesicles, and the reduction of low-grade gut inflammation. Clinical evidence from large-scale meta-analyses confirms that L. reuteri DSM 17938 is significantly superior to placebo, particularly in breastfed infants, where it is twice as likely to achieve a 50% reduction in crying time within 14-21 days of treatment. However, its efficacy appears less predictable in formula-fed populations, potentially due to the absence of synergistic factors found in human milk. Clinical management in primary care should prioritize a rigorous diagnostic approach to rule out organic causes through a detailed physical examination and the application of the Rome IV criteria. The cornerstone of non-pharmacological management remains empathetic parental reassurance and education to mitigate the risk of infant abuse and support family well-being. When probiotic intervention is indicated, L. reuteri DSM 17938 represents a robust, evidence-based first-line therapy for healthy, full-term infants. Regarding safety, this strain maintains an excellent profile supported by its generally recognized as safe (GRAS) status, with no significant adverse effects reported in healthy populations. Nevertheless, recent clinical scrutiny emphasizes the need for caution and the use of pharmaceutical-grade products in vulnerable groups. Ultimately, L. reuteri DSM 17938 addresses both the biological triggers of colic and the psychosocial stability of the family unit.

En este trabajo se caracterizó el campo de esfuerzos tectónicos de la microplaca de Panamá mediante el análisis de la sismicidad ocurrida entre los años 2015 y 2019. Para ello, se utilizaron eventos sísmicos con magnitudes iguales o superiores a Mw 4.0, registrados por el Instituto de Geociencias de la Universidad de Panamá, lo que permitió disponer de una base de datos robusta de 965 sismos. A partir de estos registros, se determinaron 275 mecanismos focales confiables mediante el análisis de las polaridades de la onda P, garantizando la calidad de la información empleada. Con los mecanismos focales obtenidos, se calcularon los tensores de esfuerzo en nueve de las diez regiones sismogénicas definidas en el estudio, utilizando el programa Win Tensor. Este análisis permitió estimar parámetros fundamentales como la orientación de los ejes principales de esfuerzo (??, ?? y ??), los coeficientes R y R?, los tipos de régimen tectónico y la dirección del esfuerzo máximo horizontal (SHmax). Los resultados fueron representados mediante mapas elaborados con el software Generic Mapping Tool (GMT) y visualizados en la plataforma CASMO del Mapa Mundial de Esfuerzos. Los mapas obtenidos revelan una notable heterogeneidad espacial en los regímenes de esfuerzo dentro de la microplaca de Panamá. Se identificaron zonas dominadas por esfuerzos compresivos, extensivos, de rumbo y regímenes mixtos. Regiones como Punta Burica muestran coexistencia de regímenes compresivos y extensivos, mientras que en Panamá Este predominan regímenes extensivos y compresivos con componente de rumbo. En la región de Talamanca, en la frontera Panamá–Costa Rica, también se evidencian regímenes tectónicos complejos. En conjunto, este estudio aporta una visión integral de la dinámica tectónica de la microplaca de Panamá, destacando su complejidad estructural y contribuyendo al entendimiento regional de los procesos sísmicos y tectónicos activos.