Institution
Pan American Health Organization
Healthcare•Havana, Cuba•
About: Pan American Health Organization is a healthcare organization based out in Havana, Cuba. It is known for research contribution in the topics: Population & Public health. The organization has 1500 authors who have published 2263 publications receiving 83705 citations. The organization is also known as: HO Regional Office for the Americas.
Topics: Population, Public health, Health care, Latin Americans, Vaccination
Papers published on a yearly basis
Papers
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TL;DR: Despite gaps in the evidence base, current knowledge is sufficient to make practical recommendations to guide appropriate evaluation, management, and etiologic treatment of Chagas disease.
Abstract: ContextBecause of population migration from endemic areas and newly instituted blood bank screening, US clinicians are likely to see an increasing number of patients with suspected or confirmed chronic Trypanosoma cruzi infection (Chagas disease).ObjectiveTo examine the evidence base and provide practical recommendations for evaluation, counseling, and etiologic treatment of patients with chronic T cruzi infection.Evidence AcquisitionLiterature review conducted based on a systematic MEDLINE search for all available years through 2007; review of additional articles, reports, and book chapters; and input from experts in the field.Evidence SynthesisThe patient newly diagnosed with Chagas disease should undergo a medical history, physical examination, and resting 12-lead electrocardiogram (ECG) with a 30-second lead II rhythm strip. If this evaluation is normal, no further testing is indicated; history, physical examination, and ECG should be repeated annually. If findings suggest Chagas heart disease, a comprehensive cardiac evaluation, including 24-hour ambulatory ECG monitoring, echocardiography, and exercise testing, is recommended. If gastrointestinal tract symptoms are present, barium contrast studies should be performed. Antitrypanosomal treatment is recommended for all cases of acute and congenital Chagas disease, reactivated infection, and chronic T cruzi infection in individuals 18 years or younger. In adults aged 19 to 50 years without advanced heart disease, etiologic treatment may slow development and progression of cardiomyopathy and should generally be offered; treatment is considered optional for those older than 50 years. Individualized treatment decisions for adults should balance the potential benefit, prolonged course, and frequent adverse effects of the drugs. Strong consideration should be given to treatment of previously untreated patients with human immunodeficiency virus infection or those expecting to undergo organ transplantation.ConclusionsChagas disease presents an increasing challenge for clinicians in the United States. Despite gaps in the evidence base, current knowledge is sufficient to make practical recommendations to guide appropriate evaluation, management, and etiologic treatment of Chagas disease.
720 citations
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TL;DR: Governments should implement policies to prevent donations of blood and organs from T. cruzi infected donors and an infrastructure that assures detection and treatment of acute and chronic cases as well as congenital infection should be developed.
701 citations
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TL;DR: The aim of this study was to provide evidence that palliative care and pain relief research should be considered as a continuum of treatment for patients with life-threatening illnesses.
683 citations
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Harvard University1, Pan American Health Organization2, Livestrong Foundation3, The Global Fund to Fight AIDS, Tuberculosis and Malaria4, American Society of Clinical Oncology5, China Medical Board6, University of California, San Francisco7, Seattle Cancer Care Alliance8, Global Forum for Health Research9, Imperial College London10, Public Health Foundation of India11, Columbia University12, King Hussein Cancer Center13, American Cancer Society14
TL;DR: The public health community's assumption that cancers will remain untreated in poor countries is challenged, and the analogy to similarly unfounded arguments from more than a decade ago against provision of HIV treatment is noted.
662 citations
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TL;DR: The roadmap for the control and elimination of the more widespread NTDs will require an inter-sectoral approach that bridges public health, social services, and environmental interventions.
Abstract: The neglected tropical diseases (NTDs) represent some of the most common infections of the poorest people living in the Latin American and Caribbean region (LAC). Because they primarily afflict the disenfranchised poor as well as selected indigenous populations and people of African descent, the NTDs in LAC are largely forgotten diseases even though their collective disease burden may exceed better known conditions such as of HIV/AIDS, tuberculosis, or malaria. Based on their prevalence and healthy life years lost from disability, hookworm infection, other soil-transmitted helminth infections, and Chagas disease are the most important NTDs in LAC, followed by dengue, schistosomiasis, leishmaniasis, trachoma, leprosy, and lymphatic filariasis. On the other hand, for some important NTDs, such as leptospirosis and cysticercosis, complete disease burden estimates are not available. The NTDs in LAC geographically concentrate in 11 different sub-regions, each with a distinctive human and environmental ecology. In the coming years, schistosomiasis could be eliminated in the Caribbean and transmission of lymphatic filariasis and onchocerciasis could be eliminated in Latin America. However, the highest disease burden NTDs, such as Chagas disease, soil-transmitted helminth infections, and hookworm and schistosomiasis co-infections, may first require scale-up of existing resources or the development of new control tools in order to achieve control or elimination. Ultimately, the roadmap for the control and elimination of the more widespread NTDs will require an inter-sectoral approach that bridges public health, social services, and environmental interventions.
655 citations
Authors
Showing all 1503 results
Name | H-index | Papers | Citations |
---|---|---|---|
Marcello Tonelli | 128 | 701 | 115576 |
Stephen L. Hoffman | 104 | 458 | 38597 |
Peter Singer | 94 | 702 | 37128 |
James C. Anthony | 94 | 401 | 43875 |
Bruce G. Link | 92 | 307 | 45777 |
Andrew E. Skodol | 88 | 252 | 24975 |
Marie T. Ruel | 77 | 300 | 22862 |
Franco M. Muggia | 64 | 393 | 18587 |
María G. Guzmán | 63 | 272 | 15992 |
Rob McConnell | 63 | 250 | 17973 |
José M. Belizán | 53 | 198 | 11892 |
Agustin Conde-Agudelo | 52 | 87 | 12009 |
Denise L. Doolan | 49 | 199 | 10581 |
Brendan Flannery | 48 | 177 | 8004 |
Martha Sedegah | 45 | 120 | 9304 |