La Paz

Researchers are studying the effects of living at high altitude during pregnancy by following two groups of healthy pregnant women one group residing at elevations above 3,500 meters and another residing at sea level. The study aims to understand how chronic low oxygen levels at high altitudes affect heart function, especially the right side of the heart, fetal growth, and the role of nitric oxide in pregnancy complications related to blood vessel and heart function. The study involves detailed heart ultrasound examinations to assess right heart anatomy and function, including measurements of pulmonary artery pressure and right ventricular performance. Researchers will also track fetal growth before and after birth, examine placental characteristics, and measure nitric oxide-related substances in maternal blood, umbilical cord blood, and placental tissue. These assessments will be correlated with oxygen levels and altitude exposure. Flow-mediated dilation tests will be performed in the high altitude group to evaluate blood vessel function. Participants will be monitored through late pregnancy around 35 weeks and into the postpartum period about 6 weeks after delivery. Researchers will collect data on heart and fetal measurements, nitric oxide levels, and birth weight. This comprehensive monitoring aims to clarify how high altitude impacts cardiovascular health and fetal development during and after pregnancy, with ongoing follow-up until postpartum.

Researchers are investigating how geographic altitude and the availability of critical care resources affect health outcomes in children with pediatric acute respiratory distress syndrome PARDS. This multicenter observational study collects data on patient demographics, physiology, and hospital structures from pediatric intensive care units PICUs located at various altitudes worldwide. The goal is to identify differences in PARDS management and develop recommendations tailored to diverse healthcare settings. Participants are grouped based on the altitude of the PICU where they receive care low altitude 0-1500 meters, intermediate altitude 1501-2500 meters, high altitude 2501-3500 meters, and very high altitude above 3500 meters. No treatments are given as part of the study instead, the focus is on observing and analyzing existing care practices and patient outcomes across these different altitude groups. Throughout the study, researchers will collect clinical, physiological, and institutional data from children admitted to PICUs requiring mechanical ventilation and diagnosed with PARDS. They will measure key outcomes such as in-hospital mortality up to 90 days, new health issues at discharge, ventilator-free days, and ICU-free days within 28 days. The study aims to provide evidence to improve critical care practices for children with PARDS globally. Participation may last until hospital discharge or up to 90 days after PICU admission.

Researchers are evaluating the combination of inhaled pentamidine and oral miltefosine as a treatment for mucosal leishmaniasis caused by Leishmania braziliensis in Bolivia. Mucosal leishmaniasis is a severe form of the disease that damages the nose, throat, and related areas and is difficult to cure with traditional treatments. This phase 2 study aims to improve cure rates, especially for moderate to severe cases, by using a non-intravenous drug combination. Participants will receive oral miltefosine three times daily for 28 days and inhaled pentamidine at 300 mg on specific days 1, 3, 5, 8, 10, 12, 15, 17, 19, and 22. The study plans to enroll 20 patients with moderate to severe disease and up to 10 patients with milder cases. This combination therapy is fully non-parenteral and is expected to minimize overlapping side effects. During the study, researchers will monitor patients for effectiveness of the treatment over 25 months and track any treatment-emergent side effects for 6 months. Patients will undergo evaluations by ENT specialists and parasitological confirmation tests before enrollment. The study includes safety assessments such as blood tests, liver and kidney function monitoring, and heart evaluations. Participants will be followed throughout the treatment and for an extended period to assess cure and safety outcomes.