Current knowledge of Chagas-related heart disease among pediatric cardiologists in the United States

Abstract Background Chagas disease is a pathogenic parasitic infection with approximately 8 million cases worldwide and greater than 300,000 cases in the United States (U.S.). Chagas disease can lead to chronic cardiomyopathy and cardiac complications, with variable cardiac presentations in pediatrics making it difficult to recognize. The purpose of our study is to better understand current knowledge and experience with Chagas related heart disease among pediatric cardiologists in the U.S. Methods We prospectively disseminated a 19-question survey to pediatric cardiologists via 3 pediatric cardiology listservs. The survey included questions about demographics, Chagas disease presentation and experience. Results Of 139 responses, 119 cardiologists treat pediatric patients in the U.S. and were included. Most providers (87%) had not seen a case of Chagas disease in their practice; however, 72% also had never tested for it. The majority of knowledge-based questions about Chagas disease cardiac presentations were answered incorrectly, and 85% of providers expressed discomfort with recognizing cardiac presentations in children. Most respondents selected that they would not include Chagas disease on their differential diagnosis for presentations such as conduction anomalies, myocarditis and/or apical aneurysms, but would be more likely to include it if found in a Latin American immigrant. Of respondents, 87% agreed that they would be likely to attend a Chagas disease-related lecture. Conclusions Pediatric cardiologists in the U.S. have seen very few cases of Chagas disease, albeit most have not sent testing or included it in their differential diagnosis. Most individuals agreed that education on Chagas disease would be worth-while.

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Current knowledge of Chagas-related heart disease among pediatric cardiologists in the United States

10.21203/rs.3.rs-91661/v1 ◽

2020 ◽

Author(s):

Sanchi Malhotra ◽

Imran Masood ◽

Noberto Giglio ◽

Jay D. Pruetz ◽

Pia S. Pannaraj

Keyword(s):

United States ◽

Differential Diagnosis ◽

Heart Disease ◽

Chagas Disease ◽

Latin American ◽

Current Knowledge ◽

Parasitic Infection ◽

The United States ◽

Cardiac Complications ◽

The U.S

Abstract BackgroundChagas disease is a pathogenic parasitic infection with approximately 8 million cases worldwide and greater than 300,000 cases in the United States (U.S.). Chagas disease can lead to chronic cardiomyopathy and cardiac complications, with variable cardiac presentations in pediatrics making it difficult to recognize. The purpose of our study is to better understand current knowledge and experience with Chagas related heart disease among pediatric cardiologists in the U.S.MethodsWe prospectively disseminated a 19-question survey to pediatric cardiologists via 3 pediatric cardiology listservs. The survey included questions about demographics, Chagas disease presentation and experience.ResultsOf 139 responses, 119 cardiologists treat pediatric patients in the U.S. and were included. Most providers (87%) had not seen a case of Chagas disease in their practice; however, 72% also had never tested for it. The majority of knowledge-based questions about Chagas disease cardiac presentations were answered incorrectly, and 85% of providers expressed discomfort with recognizing cardiac presentations in children. Most respondents selected that they would not include Chagas disease on their differential diagnosis for presentations such as conduction anomalies, myocarditis and/or apical aneurysms, but would be more likely to include it if found in a Latin American immigrant. Of respondents, 87% agreed that they would be likely to attend a Chagas disease-related lecture.ConclusionsPediatric cardiologists in the U.S. have seen very few cases of Chagas disease, albeit most have not sent testing or included it in their differential diagnosis. Most individuals agreed that education on Chagas disease would be worth-while.

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#60: Knowledge of Diagnosis and Management of Chagas-related Heart Disease Among Pediatric Cardiologists in the United States

Journal of the Pediatric Infectious Diseases Society ◽

10.1093/jpids/piaa170.066 ◽

2021 ◽

Vol 10 (Supplement_1) ◽

pp. S21-S21

Author(s):

Sanchi Malhotra ◽

Imran Masood ◽

Noberto Giglio ◽

Jay Pruetz ◽

Pia Pannaraj

Keyword(s):

United States ◽

Differential Diagnosis ◽

Heart Disease ◽

Chagas Disease ◽

Latin American ◽

The United States ◽

Educational Programs ◽

Childbearing Age ◽

American Patient ◽

The Impact

Abstract Background Chagas disease is a highly pathogenic infection with a prevalence of approximately 5.7 million cases worldwide and greater than 300,000 cases in the United States. Up to 40% of immigrants to the United States are from highly endemic Latin American countries. An estimated 40,000 women of childbearing age in the United States are infected, with a 1–5% risk of vertical transmission. The impact of this disease is extensive, often life-long, and difficult to eradicate. The purpose of our study was to better understand current knowledge and experience among pediatric cardiologists in the United States with the cardiac presentations of Chagas disease to determine where to focus educational programs and critical content. Methods We prospectively disseminated a 19-question survey to pediatric cardiologists via the PediHeart, WSOPC, and Pediatric CHF listservs three times between September and November 2019. The survey included demographic, multiple-choice and Likert-scale questions. We used Qualtrics to ensure anonymity. Respondents outside of the United States were excluded. Results Of 140 responses received, 120 cardiologists treated pediatric patients in the United States. Over half (62.5%) of respondents served a >10% Latin American patient population. Most providers (87%) had not seen a case of Chagas disease in their practice; however, most (72%) also had never tested for Chagas. In response to the statement: “I feel comfortable recognizing cardiac presentations of Chagas disease in children”, (85%) of respondents disagreed. Most respondents selected that they would not include Chagas on their differential diagnosis for cardiac presentations that included conduction anomalies, myocarditis, and/or apical aneurysms (Figure 1). However, when considering patients who recently immigrated from Latin American nations, inclusion of Chagas in the differential diagnosis increased. In response to the statement: “If I was offered a lecture on Chagas-related heart disease, I would be likely to attend,” 87% of respondents agreed. Conclusions In our sample of pediatric cardiologists, very few had seen cases of Chagas disease, albeit very few tested for it or included it in their differential diagnosis. However, most individuals agreed that education on Chagas disease would be worth-while. Education could help ensure these cases are not missed in pediatrics. Future analysis should focus on changes in provider knowledge and/or testing as the incidence grows, or as educational programs are implemented.

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Drugs, Violence, and Capitalism: The Expansion of Opioid Use in the Americas

Latin American Perspectives ◽

10.1177/0094582x20975007 ◽

2020 ◽

pp. 0094582X2097500 ◽

Cited By ~ 1

Author(s):

Paulo José dos Reis Pereira

Keyword(s):

United States ◽

Latin American ◽

International Security ◽

Control Policy ◽

The United States ◽

Rapid Rise ◽

Opioid Use ◽

The Past ◽

Emergency Measures ◽

The U.S

In the past two decades, the United States has experienced a rapid rise in the use of opioids by its population, a context that has come to be assessed by the U.S. government as a threat to national and international security that requires emergency measures. The strategies of the U.S. government and transnational pharmaceutical corporations for resolving the insecurity generated by capitalist accumulation constitute what a certain literature calls “pacification.” In addition, these corporations export to the “foreign” the contradictions inherent in the opioid control policy that underlies the capitalist logic of drugs. Thus Latin American populations have been instrumentalized in the “solution” of this crisis either as a focus of violence by the state or as a focus of consumption by the market. Nas últimas duas décadas, os Estados Unidos vivenciaram uma rápida ascensão do uso de opioides pela sua população, contexto que passou a ser avaliado pelo governo estadunidense como uma ameaça à segurança nacional e internacional que demanda medidas emergenciais. As estratégias do Estado estadunidense e das corporações farmacêuticas transnacionais para solucionar a insegurança gerada pela acumulação capitalista configuram o que certa literatura chama “pacificação” Ademais, elas exportam para o “estrangeiro” as contradições próprias da política de controle de opioides que fundamenta a lógica capitalista das drogas. Assim, populações latino-americanas têm sido instrumentalizadas para a “solução” dessa crise, seja como foco da violência pelo Estado, seja como foco do consumo pelo mercado.

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Latino Workers

10.1093/acrefore/9780199329175.013.650 ◽

2021 ◽

Author(s):

Emiliano Aguilar

Keyword(s):

United States ◽

Latin American ◽

The United States ◽

Service Work ◽

Economic Sectors ◽

Labor Activism ◽

Latino Workers ◽

American Society ◽

The 19Th Century ◽

The U.S

Since the U.S. acquisition of Northern Mexico in the 19th century, Latinas and Latinos have played an ever-growing role as workers in the United States. The continued migration from Latin American countries has increased the importance of Latinas and Latinos across various economic sectors. As diverse as the Latina/o community itself, the array of jobs Latinas/os/xs have held has been enormously varied. As an increasing demographic of workers, Latina and Latino workers have also played a pivotal role in the labor movement in the United States. Their labor activism has been a response to the persistence of oppression and marginalization in the workplace. The presence of Latinas/os/xs in a variety of occupations offers a glimpse into the overall transitions of the U.S. economy, from agricultural to manufacturing to service work. Their movement from farm to factory to service work is of course not universal, as Latinas/os/xs still have a considerable presence in agricultural and industrial employment. Yet the transition from one kind of work to another remains a useful way of understanding the history of Latina/o/x labor over time. Latinas/os/xs have often stood at the forefront of shifts in the economy as they have followed the need for workers into new industries, which has placed them among some of the most vulnerable workers in American society.

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Marinera with the Yankees

Haya de la Torre and the Pursuit of Power in Twentieth-Century Peru and Latin America ◽

10.5149/northcarolina/9781469636573.003.0004 ◽

2018 ◽

pp. 91-124

Author(s):

Iñigo García-Bryce

Keyword(s):

United States ◽

Latin America ◽

Cold War ◽

Latin American ◽

State Department ◽

The United States ◽

Political Asylum ◽

Student Leader ◽

The Cold War ◽

The U.S

This chapter explores Haya’s changing relationship with the United States. As an exiled student leader he denounced “Yankee imperialism” and alarmed observers in the U.S. State Department. Yet once he entered Peruvian politics, Haya understood the importance of cultivating U.S.-Latin American relations. While in hiding he maintained relations with U.S. intellectuals and politicians and sought U.S. support for his embattled party. His writings increasingly embraced democracy and he maneuvered to position APRA as an ally in the U.S. fight fascism during the 1930s and 40s, and then communism during the Cold War. The five years he spent in Lima’s Colombian embassy awaiting the resolution of his political asylum case, made him into an international symbol of the democratic fight against dictatorship. He would always remain a critic of U.S. support for dictatorships in Latin America.

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Neoliberalism and Counterinsurgency

Colombia ◽

10.1093/wentk/9780190262754.003.00015 ◽

2020 ◽

Author(s):

Richard D. Mahoney

Keyword(s):

United States ◽

Free Trade ◽

Latin American ◽

North American ◽

Free Trade Agreement ◽

Trade Agreement ◽

The United States ◽

The North ◽

Trade Promotion ◽

The U.S

How did the U.S.-Colombia free trade agreement come about? The officially named “U.S.-Colombia Trade Promotion Agreement” was the stepchild of a rancorous hemispheric divorce between the United States and five Latin American governments over the proposal to extend the North American Free Trade Agreement...

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Latin American Immigration to the United States

Daedalus ◽

10.1162/daed_a_00218 ◽

2013 ◽

Vol 142 (3) ◽

pp. 48-64 ◽

Cited By ~ 19

Author(s):

Marta Tienda ◽

Susana M. Sánchez

Keyword(s):

United States ◽

Latin American ◽

The United States ◽

Children Of Immigrants ◽

Foreign Born ◽

Cumulative Impact ◽

Political Conflicts ◽

Latin American Immigration ◽

The U.S ◽

Over Time

This essay provides an overview of immigration from Latin America since 1960, focusing on changes in both the size and composition of the dominant streams and their cumulative impact on the U.S. foreign-born population. We briefly describe the deep historical roots of current migration streams and the policy backdrop against which migration from the region surged. Distinguishing among the three major pathways to U.S. residence – family sponsorship, asylum, and unauthorized entry – we explain how contemporary flows are related both to economic crises, political conflicts, and humanitarian incidents in sending countries, but especially to idiosyncratic application of existing laws over time. The concluding section highlights the importance of investing in the children of immigrants to meet the future labor needs of an aging nation.

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The Decline in U.S. Cancer Mortality from 1991 to 1995: What's behind the Numbers?

International Journal of Health Services ◽

10.2190/mu87-5mmv-buk3-l7gk ◽

1998 ◽

Vol 28 (4) ◽

pp. 747-755 ◽

Cited By ~ 4

Author(s):

Richard W. Clapp

Keyword(s):

United States ◽

Heart Disease ◽

Racial Disparities ◽

Cancer Mortality ◽

Turning Point ◽

The United States ◽

Cancer Burden ◽

News Stories ◽

Disease Mortality ◽

The U.S

In 1996, a series of articles and news stories about cancer mortality in the United States proclaimed a “turning point in the 25-year war on cancer.” While these articles and stories pointed to a recent decline in overall cancer mortality, they missed some important points about increases in specific types. They also ignored the politics behind the emphasis on smoking and diet as the main contributors to the cancer rates and the racial disparities in the U.S. data. In addition, recent articles on the decline in cancer mortality fail to note the much sharper decline in heart disease mortality. Continued efforts to reduce carcinogenic exposures at work and in the environment are needed to truly reduce the cancer burden.

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Atoms for Peace in Latin America

Oxford Research Encyclopedia of Latin American History ◽

10.1093/acrefore/9780199366439.013.317 ◽

2016 ◽

Cited By ~ 2

Author(s):

Gisela Mateos ◽

Edna Suárez-Díaz

Keyword(s):

United States ◽

Latin America ◽

Latin American ◽

Nuclear Weapons ◽

Technical Assistance ◽

The United States ◽

Nuclear Industry ◽

Atomic Energy ◽

Latin American Countries ◽

The U.S

On December 8, 1953, in the midst of increasing nuclear weapons testing and geopolitical polarization, United States President Dwight D. Eisenhower launched the Atoms for Peace initiative. More than a pacifist program, the initiative is nowadays seen as an essential piece in the U.S. defense strategy and foreign policy at the beginning of the Cold War. As such, it pursued several ambitious goals, and Latin America was an ideal target for most of them: to create political allies, to ease fears of the deadly atomic energy while fostering receptive attitudes towards nuclear technologies, to control and avoid development of nuclear weapons outside the United States and its allies, and to open or redirect markets for the new nuclear industry. The U.S. Department of State, through the Foreign Operations Administration, acted in concert with several domestic and foreign middle-range actors, including people at national nuclear commissions, universities, and industrial funds, to implement programs of regional technical assistance, education and training, and technological transfer. Latin American countries were classified according to their stage of nuclear development, with Brazil at the top and Argentina and Mexico belonging to the group of “countries worthy of attention.” Nuclear programs often intersected with development projects in other areas, such as agriculture and public health. Moreover, Eisenhower’s initiative required the recruitment of local actors, natural resources and infrastructures, governmental funding, and standardized (but localized techno-scientific) practices from Latin American countries. As Atoms for Peace took shape, it began to rely on newly created multilateral and regional agencies, such as the International Atomic Energy Agency (IAEA) of the United Nations and the Inter-American Nuclear Energy Commission (IANEC) of the Organization of American States (OAS). Nevertheless, as seen from Latin America, the implementation of atomic energy for peaceful purposes was reinterpreted in different ways in each country. This fact produced different outcomes, depending on the political, economic, and techno-scientific expectations and interventions of the actors involved. It provided, therefore, an opportunity to create local scientific elites and infrastructure. Finally, the peaceful uses of atomic energy allowed the countries in the region to develop national and international political discourses framing the Treaty for the Prohibition of Nuclear Weapons in Latin America and the Caribbean signed in Tlatelolco, Mexico City, in 1967, which made Latin America the first atomic weapons–free populated zone in the world.

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With a Little Help from my Friends

Comparative Political Studies ◽

10.1177/0010414004274402 ◽

2005 ◽

Vol 38 (8) ◽

pp. 971-999 ◽

Cited By ~ 77

Author(s):

M. Victoria Murillo ◽

Andrew Schrank

Keyword(s):

United States ◽

Latin America ◽

Latin American ◽

Trade Unions ◽

The United States ◽

Labor Rights ◽

Labor Laws ◽

The Cost ◽

The Relationship ◽

The U.S

Why did Latin American governments adopt potentially costly, union-friendly labor reforms in the cost-sensitive 1980s and 1990s? The authors answer the question by exploring the relationship between trade unions and two of their most important allies: labor-backed parties at home and labor rights activists overseas. While labor-backed parties in Latin America have locked in the support of their core constituencies by adopting relatively union-friendly labor laws in an otherwise uncertain political and economic environment, labor rights activists in the United States have demonstrated their support for their Latin American allies by asking the U.S. government to treat the protection of labor rights as the price of access to the U.S. market. The former trajectory is the norm in traditionally labor-mobilizing polities, where industrialization encouraged the growth of labor-backed parties in the postwar era; the latter is more common in more labor-repressive environments, where vulnerable unions tend to look for allies overseas.

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