The number of migrants, which includes forcibly displaced refugees, asylum seekers, and undocumented persons, is increasing worldwide. The global migrant population is heterogeneous in terms of medical conditions and vulnerability resulting from non-optimal metabolic risk factors in the country of origin (e.g., abnormal adiposity, dysglycemia, hypertension, and dyslipidemia), adverse travel conditions and the resulting stress, poverty, and anxiety, and varying effects of acculturation and access to healthcare services in the country of destination. Therefore, many of these migrants develop a high risk for cardiovascular disease and face the significant challenge of overcoming economic and health system barriers to accessing quality healthcare. In the host countries, healthcare professionals experience difficulties providing care to migrants, including cultural and language barriers, and limited institutional capacities, especially for those with non-legal status. Telehealth is an effective strategy to mitigate cardiometabolic risk factors primarily by promoting healthy lifestyle changes and pharmacotherapeutic adjustments. In this descriptive review, the role of telehealth in preventing the development and progression of cardiometabolic disease is explored with a specific focus on type 2 diabetes and hypertension in forcibly displaced migrants. Until now, there are few studies showing that culturally adapted telehealth services can decrease the burden of T2D and HTN. Despite study limitations, telehealth outcomes are comparable to those of traditional health care with the advantages of having better accessibility for difficult-to-reach populations such as forcibly displaced migrants and reducing healthcare associated costs. More prospective studies implementing telemedicine strategies to treat cardiometabolic disease burden in migrant populations are needed.

Obesity is defined as excess adipose tissue; however, commonly used methods may under-detect adiposity in adolescents. This study compared the performance of body mass index percentile (BMI%) and relative body mass index (RBMI) in identifying excess body fat percentage (BF%) and estimated RBMI cut points to better stratify severity of adiposity. In 567 adolescents ages 11–19 year, BF% measured by DXA was used to compare BMI% and RBMI performance at different degrees of adiposity. RBMI cut points for adiposity detection were derived via ROC curve analysis. BF% was strongly correlated with BMI% (r = 0.889, p < 0.001) and RBMI (r = 0.901, p < 0.001). However, RBMI exhibited less dispersion and better discriminated the relationship with BF% independent of age, race, and gender. Both BMI% and RBMI performed similarly for detecting high BF% (≥25 BF% in males; ≥30 BF% in females). Nonetheless, the relationship of BMI% with BF% was diminished among leaner adolescents. RBMI detected overweight in 21.3% more females and 14.2% more males. RBMI improved the detection of excess adiposity in individuals otherwise classified as having normal weight or overweight by BMI%. RBMI is a valuable and accessible tool for earlier detection, intervention, and effective follow-up of excess adiposity in youth at higher risk for complications.

Background: Heart failure (HF) impacts over 56 million people worldwide, with significantly higher mortality rates in low and low-middle-income countries (LIC/LMICs). Despite the effectiveness of guideline-directed medical therapy (GDMT) for HF with reduced ejection fraction (HFrEF), its use remains limited in LIC/LMICs due to limited availability and affordability. These barriers are particularly pressing in Venezuela’s context, as the country faces an ongoing crisis. Objective: Describe price and affordability of HF Guideline Directed Medical Therapy at optimal dosages in Venezuela. Methods: We conducted a cross-sectional analysis from December 2023 to January 2024, surveying prices of HF GDMT medications across 13 major pharmacy networks in Venezuela. Medications analyzed included ACE inhibitors (ACEi), angiotensin receptor blockers (ARB), beta-blockers (BB), mineralocorticoid receptor antagonists (MRA), angiotensin receptor-neprilysin inhibitors (ARNI), and sodium-glucose co-transporter 2 inhibitors (SGLT2i). Affordability was defined and calculated using the World Health Organization/Health Action International (WHO/HAI) methodology, comparing the median costs of one month of HF GDMT at optimal dosages to the lowest-paid government worker’s (LPGW) daily wages. Other comparisons of price affordability were made against the mean daily salary of managers, professional and non-professional workers in the country. Results: The most expensive medication regime for HF in Venezuela was ARNI-based GDMT with a median monthly cost of 393.81USD, followed by ARB-based GDMT and ACEi-based GDMT costing $100.88USD and $82.23USD respectively. meaning LPGW and elderly receiving retirement stipends would need between 506 to 2421 paid work days to cover one month of treatment at optimal dosages. Conclusion: Based on the WHO/HAI methodology all HF GDMT regimens were deemed unaffordable in Venezuela. Similar affordability challenges exist in other LIC/LMICs countries highlighting the need for global advocacy and policy action to address financial barriers to access guideline-based heart failure care.

Objective: The MEchanick Transculturalization Research and Innovation ConSortium/Bernard Lown Scholars in Cardiovascular Health Program Consensus Conference on Dysglycemia‑Based Chronic Disease (DBCD) Transculturalization in Chile convened on November 20, 2023, in Santiago, Chile. The conference generated affirmed and emergent concepts, key strategies, and specific implementation tactics to improve type 2 diabetes (T2D) care in Chile. Findings: Important affirmed concepts included: (1) implementing a comprehensive approach to T2D management beyond glycemic control; (2) addressing unique challenges for early detection and treatment of T2D; and (3) applying expanded roles of telemedicine. Important emergent concepts included: (1) adopting transculturalized chronic care models such as DBCD; (2) recognizing prediabetes as a critical DBCD target to prevent T2D and T2D complications, especially cardiovascular disease; and (3) implementation of the DBCD model for individual and population health. Key strategies included: (1) validation of culturally adapted T2D risk assessment tools; (2) integration of social determinants of health (SDOH) and ethnocultural factors into DBCD care strategies/tactics; and (3) promotion of equity in healthcare access for all people comprising diverse populations. Finally, specific implementation tactics included: (1) focusing on patient‑centered public policies; (2) ensuring access to effective treatments; and (3) using culturally relevant resources for education and prevention. When coordinated, these strategies and tactics mitigate DBCD progression, thereby enhancing healthcare outcomes. Conclusions and recommendations: Expert consensus emphasizes the need for a comprehensive approach to T2D management in Chile, leveraging transculturalized lifestyle medicine, validated risk assessment tools, SDOH, and patient‑centered public policies. This process should begin with incorporating eHealth technologies, validation studies, and then translation into clinical practice guidelines. As this templated methodology is applied to other regions of the world, the resulting compendium of concepts, strategies, and tactics can foment a more effective preventive health culture and optimize DBCD care across the ethnocultural spectrum.

Worldwide, thrombocytopenia is one of the first causes of hematological alterations in pregnancy, affecting up to 10% of them. Despite the fact that all clinical entities with thrombocytopenia in pregnancy have a similar clinical spectrum, the distinction between them is vital to establish the appropriate treatment and thus reduce maternal-fetal morbidity and mortality. Purpura thrombotic thrombocytopenic is an infrequent disease, which despite not being linked to pregnancy, is not exempt from occurring in it, compared to HELLP syndrome, which is a multisystemic complication that occurs during pregnancy. The following is the case of a pregnant woman with microangiopathic thrombocytopenic anemia where the clinical similarity of both pathologies is evidenced, representing a diagnostic challenge. Keywords: Thrombocytopenia, Pregnancy, HELLP Syndrome, Purpura thrombotic thrombocytopenic, Anemia.