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Objective: To synthesize the international evidence on the impact of clean intermittent catheterization on quality of life and resource utilization in patients with spinal cord injury and urological complications, to support a review of policies that shift the financial burden of catheterization to families in Chile.

Methods: A narrative review based on the MEDLINE/PubMed database and gray literature published between 2014 and 2025, in Spanish and English. The research question was structured using the population, concept, and context framework. Two search algorithms were applied, combining MeSH terms, free-text keywords, and Boolean operators. Screening was conducted in three successive stages (title, abstract, and full text), with a second reviewer resolving any uncertainties by consensus.

Results: After screening 880 references, 65 studies met the inclusion criteria. Findings were organized into five dimensions: patient quality of life, caregiver quality of life, urinary tract infections, resource use, and emerging care models. Based on this evidence, an archetype of the chronic catheter user was developed: a man aged between 25 and 45 with a traumatic spinal cord injury, who uses a wheelchair in more than 67% of cases, spends more than 53 minutes a day on catheterization, has a prevalence of urinary tract infection exceeding 50% (two-thirds of which are antimicrobial resistant), and reports a 36% dissatisfaction with his urinary quality of life. Furthermore, he reuses catheters primarily for economic reasons; 90% of patients who used reusable catheters preferred switching to single-use catheters, and 84% reported greater satisfaction. Multiple cost-effectiveness analyses show that hydrophilic single-use catheters are cost-effective or dominant strategies in high-income settings. Caregivers -mostly mothers or partners- report insufficient training, social restriction, and work-related difficulties that the healthcare system fails to address.

Conclusions: Access to appropriate catheterization supplies, combined with structured patient and caregiver education and continuity of care, improves quality of life, reduces urinary complications, and is cost-effective. Chile's current policy of shifting the financial burden of catheterization to families is inconsistent with the available international evidence.

Genomic medicine has introduced transformative tools for psychiatric practice, facilitating the diagnosis of complex cases through the identification of genetic variants. The gene encodes a key component of the histone methyltransferase complex. Mutations in this gene have been linked to neurodevelopmental disorders and schizophrenia, particularly in cases with early onset and cognitive impairment. The aim of this article is to describe the application of genomic tools and international criteria for interpreting genetic pathogenicity in psychiatric clinical practice, using as a model. Based on an illustrative clinical case of a 13-year-old patient with psychotic symptoms, we conducted a comparative analysis of two single-nucleotide variants in (c.2209C>A and c.2209C>T). Genomic databases (Ensembl, ClinVar, gnomAD) and prediction tools (PolyPhen-2, MutationTaster, Align-GVGD) were used, following the American College of Medical Genetics and Genomics guidelines. The c.2209C>T (nonsense) variant was classified as pathogenic due to its truncating effect and prior reports. In contrast, the c.2209C>A (missense) variant, initially of uncertain significance, was reclassified as likely benign after a familial segregation study showed the variant was inherited from an unaffected parent. The integration of genomic tools allows for a precise approach to neuropsychiatric phenotypes. However, bioinformatic analysis must be complemented by clinical correlation and cosegregation studies. Finally, genetic counseling is emphasized as an essential process to integrate technical findings with the psychological and educational needs of the patient and their family.

Chagasic cardiomyopathy is the chronic manifestation of American trypanosomiasis. In endemic regions of Peru, delayed diagnosis remains a major public health concern. This review analyzes recent evidence (2020 to 2026) regarding the impact of genetic variants on severity, the utility of cardiac magnetic resonance imaging, and the efficacy of trypanocidal and advanced support treatment. A search was conducted in PubMed and Scopus, prioritizing clinical trials and meta-analyses. Current data challenge the direct relationship between parasite lineage and cardiac severity, highlighting the host inflammatory response as the primary driver. Diagnostically, cardiac magnetic resonance imaging surpassed echocardiography in identifying early fibrosis and defining arrhythmic risk. Regarding therapy, benznidazole use during the indeterminate phase reduced the risk of clinical progression (Relative Risk (RR) 0.35), challenging traditional palliative approaches. In conclusion, current evidence repositions etiological treatment as a viable preventive strategy and underscores the importance of cardiac magnetic resonance imaging for early clinical management.

Introduction: The Finnish Diabetes Risk Score questionnaire is a widely used tool for screening type 2 diabetes mellitus; however, its application in Indigenous populations has been little studied. This study assessed the diagnostic accuracy of this questionnaire for detecting cases consistent with type 2 diabetes mellitus in the Totonac population of the state of Puebla, Mexico, and its performance when stratified by gender.

Methods: A cross-sectional diagnostic accuracy study with prospective data collection was conducted in 148 adults (≥18 years) without a previous diagnosis of type 2 diabetes mellitus. Participants were residents of communities in the Sierra Nororiental of Puebla and were recruited through convenience sampling with consecutive enrollment during a health fair. The Finnish Diabetes Risk Score questionnaire was used as the index test, evaluated using two cutoff points (≥12 and ≥15); glycated hemoglobin (≥6.5%) was used as the reference standard. Both tests were administered independently and with assessor blinding. Sensitivity, specificity, predictive values, diagnostic accuracy, and the area under the curve were estimated through overall and gender-stratified analyses.

Results: At the ≥12 cut-off point, the Finnish Diabetes Risk Score showed an overall sensitivity of 76.4% (95%; CI: 66.6 to 84.0), specificity of 55.9% (95%; CI: 43.3 to 67.9), diagnostic accuracy of 68.2% (95%; CI: 60.4 to 75.2), and an area under the curve of 0.64 (95%; CI: 0.54 to 0.73). In women, sensitivity reached 85.2% (95%; CI: 73.4 to 92.3) and the area under the curve was 0.71 (95%; CI: 0.60 to 0.81), whereas in men the discriminative capacity was limited.

Conclusions: The Finnish Diabetes Risk Score questionnaire demonstrated moderate discriminative capacity for detecting cases compatible with type 2 diabetes mellitus in the Totonac Indigenous population, with acceptable performance in women using the cut-off point of ≥12. These findings support its use as an initial screening tool in settings with limited access to confirmatory tests and highlight the need for validation in specific contexts.

Objective: This living systematic review Version 1.0 aims to provide a timely, rigorous and continuously updated summary of the evidence on the use of acetazolamide plus loop diuretics in acute congestive heart failure compared to loop diuretics.

Methods: We conducted a comprehensive search in CENTRAL, EMBASE, MEDLINE, and between database inception and September 2025. No language, publication date or status restrictions were applied. Two reviewers independently screened eligible studies, according to predefined selection criteria, and extracted data using a predesigned form. We performed meta-analyses using random-effects models and assessed overall certainty in evidence using the GRADE approach. The quality of the evidence was assessed using the Cochrane risk-of-bias tool. This review was registered in PROSPERO (CRD42024575267).

Results: Of 732 records identified, five randomized trials were included, with a total of 1050 participants. The evidence is very uncertain about the effect of adding acetazolamide to loop diuretics in decongestion observed at 72 hours (risk ratio: 1.17, 95% confidence interval: 0.96 to 1.44). Low certainty evidence shows adding acetazolamide to loop diuretics may increase natriuresis at 24 hours (mean difference 38.43, 95% confidence interval: 19.42 to 57.43). No significant differences were found between groups in accumulative diuresis at 48 hours, all-cause mortality, readmission due to heart failure or worsening renal function.

Conclusions: Evidence suggests that it is necessary to promote further investigations regarding the use of acetazolamide plus loop diuretics in acute congestive heart failure. More robust, standardized, long-term studies are needed, and conclusions may change as new data emerge.

Introduction: Intensive care unit-acquired weakness is a condition with a substantial impact on morbidity, mortality, and long-term quality of life. Consolidated evidence on this condition in Latin America remains limited. This gap may be influenced by regional differences in healthcare systems, resource availability, and population characteristics, which restrict a comprehensive understanding of the condition in this context.

Objectives: This scoping review aims to describe and map the evidence on the clinical and epidemiological characteristics of adults hospitalized in intensive care units in Latin America with intensive care unit-acquired weakness.

Methods: This review will follow the Joanna Briggs Institute methodological framework and will be reported in accordance with the PRISMA guidelines. A search strategy will be applied across the main databases and regional repositories. Studies involving adults hospitalized in intensive care units in Latin American countries that address intensive care unit-acquired weakness will be included. Study selection and data extraction will be conducted independently by two reviewers. Extracted data will include study characteristics, demographic and clinical variables, diagnostic approaches, risk factors, and reported strategies for prevention or management.

Expected results: This review is expected to provide a comprehensive description of intensive care unit-acquired weakness in Latin America, highlighting reported clinical and epidemiological patterns, methodological heterogeneity, and both geographic and thematic knowledge gaps. The findings will help design context-specific strategies for evaluation, prevention, and rehabilitation, contributing to strengthen future research within the region.