Recent Submissions

  • Body mass index and vigorous physical activity in children and adolescents: an international cross-sectional study.

    Braithwaite, Irene E; Stewart, Alistair W; Hancox, Robert J; Murphy, Rinki; Wall, Clare R; Beasley, Richard; Mitchell, Edwin A; irene.braithwaite@mrinz.ac.nz (Blackwell Publishing Ltd, 2017-08-01)
    Aim: To examine the relationship between reported vigorous physical activity (VPA) and body mass index (BMI) in children (6–7 years) and adolescents (13–14 years). Methods: In the International Study of Asthma and Allergies in Childhood Phase Three, 75 895 children's parents and 199 502 adolescents answered questions relating to VPA, height and weight. The association between VPA and BMI was analysed using general linear models, adjusting for country gross national index. Results: Compared to children who undertook no VPA, those in the infrequent group (once or twice per week) and those in the frequent group (three or more times per week) had mean (95% CI) BMI values 0.07 kg/m 2 (0.03–0.11) and 0.09 kg/m 2 (0.03–0.15) greater, respectively (p = 0.001). Compared to adolescents reporting no VPA, those in the infrequent group had a BMI 0.19 kg/m 2 (0.15–0.23) greater while those in the frequent group had a BMI 0.01 kg/m 2 (−0.03–0.05) greater (p < 0.0001). Conclusion: Reported VPA is not associated with lower BMI among children and adolescents. Investigation of VPA and BMI may be best undertaken in conjunction with other variables in the energy expenditure equation. A focus on VPA alone may be an inefficient way to manage BMI.
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  • Association between Frequency of Consumption of Fruit, Vegetables, Nuts and Pulses and BMI: Analyses of the International Study of Asthma and Allergies in Childhood (ISAAC).

    Wall, Clare R; Stewart, Alistair W; Hancox, Robert J; Murphy, Rinki; Braithwaite, Irene; Beasley, Richard; Mitchell, Edwin A; c.wall@auckland.ac.nz (MDPI AG, 2018-03-07)
    Diets which emphasize intakes of plant-based foods are recommended to reduce disease risk and for promoting healthy weight. The aim of this study was to examine the association between fruit, vegetables, pulses and nut intake and body mass index (BMI) across countries in adolescents (13-14 years) and children (6-7 years). Data from the International Study of Asthma and Allergies in Childhood; 77,243 children's parents and 201,871 adolescents was used to examine the association between dietary intake (Food Frequency Questionnaire) and BMI using general linear models, adjusting for country gross national index. Adolescents who consumed fruit, vegetables, pulses and nuts three or more times a week had a lower BMI than the never or occasional group; eating nuts three or more times a week, was associated with a BMI value of 0.274 kg/m² lower than the never group (p < 0.001). Compared to children who never or occasionally reported eating vegetables, those reporting that they ate vegetables three or more times per week had a lower BMI of -0.079 kg/m². In this large global study, an inverse association was observed between BMI and the reported increasing intake of vegetables in 6-7 years old and fruit, vegetables, pulses and nuts in adolescents. This study supports current dietary recommendations which emphasize the consumption of vegetables, nut and pulses, although the effect sizes were small.
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  • Are environmental risk factors for current wheeze in the International Study of Asthma and Allergies in Childhood (ISAAC) phase three due to reverse causation?

    Silverwood, Richard J; Rutter, Charlotte E; Mitchell, Edwin A; Asher, M Innes; Garcia-Marcos, Luis; Strachan, David P; Pearce, Neil; Chiarella, Pascual; ISAAC Phase Three Study Group.; neil.pearce@lshtm.ac.uk (Blackwell Publishing Ltd, 2019-04-01)
    Background: Phase Three of the International Study of Asthma and Allergies in Childhood (ISAAC) measured the global prevalence of symptoms of asthma in children. We undertook comprehensive analyses addressing risk factors for asthma symptoms in combination, at both the individual and the school level, to explore the potential role of reverse causation due to selective avoidance or confounding by indication. Objective: To explore the role of reverse causation in risk factors of asthma symptoms. Methods: We compared two sets of multilevel logistic regression analyses, using (a) individual level exposure data and (b) school level average exposure (ie prevalence), in two different age groups. In individual level analyses, reverse causation is a possible concern if individual level exposure statuses were changed as a result of asthma symptoms or diagnosis. School level analyses may suffer from ecologic confounding, but reverse causation is less of a concern because individual changes in exposure status as a result of asthma symptoms would only have a small effect on overall school exposure levels. Results: There were 131 924 children aged 6-7 years (2428 schools, 25 countries) with complete exposure, outcome and confounder data. The strongest associations in individual level analyses (fully adjusted) were for current paracetamol use (odds ratio = 2.06; 95% confidence interval 1.97-2.16), early life antibiotic use (1.65; 1.58-1.73) and open fire cooking (1.44; 1.26-1.65). In school level analyses, these risk factors again showed increased risks. There were 238 586 adolescents aged 13-14 years (2072 schools, 42 countries) with complete exposure, outcome and confounder data. The strongest associations in individual level analyses (fully adjusted) were for current paracetamol use (1.80; 1.75-1.86), cooking on an open fire (1.32; 1.22-1.43) and maternal tobacco use (1.23; 1.18-1.27). In school level analyses, these risk factors again showed increased risks. Conclusions & clinical relevance: These analyses strengthen the potentially causal interpretation of previously reported individual level findings, by providing evidence against reverse causation.
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  • Are Environmental Factors for Atopic Eczema in ISAAC Phase Three due to Reverse Causation?

    Rutter, Charlotte E; Silverwood, Richard J; Williams, Hywel C; Ellwood, Philippa; Asher, Innes; Garcia-Marcos, Luis; Strachan, David P; Pearce, Neil; Langan, Sinéad M; Chiarella, Pascual; ISAAC Phase Three Study Group; Sinead.langan@lshtm.ac.uk (Elsevier B.V., 2019-05-01)
    Some previously described environmental associations for atopic eczema may be due to reverse causation. We explored the role of reverse causation by comparing individual- and school-level results for multiple atopic eczema risk factors. The International Study of Asthma and Allergies in Childhood (i.e, ISAAC) Phase Three surveyed children in schools (the sampling unit) regarding atopic eczema symptoms and potential risk factors. We assessed the effect of these risk factors on atopic eczema symptoms using mixed-effect logistic regression models, first with individual-level exposure data and second with school-level exposure prevalence. Overall, 546,348 children from 53 countries were included. At ages 6–7 years, the strongest individual-level associations were with current paracetamol use (odds ratio [OR] = 1.45, 95% confidence interval [CI] = 1.37–1.54), which persisted at school-level (OR = 1.55, 95% CI = 1.10–2.21), early-life antibiotics (OR = 1.41, 95% CI = 1.34–1.48), and early-life paracetamol use (OR = 1.28, 95% CI = 1.21–1.36), with the former persisting at the school level, whereas the latter was no longer observed (OR = 1.35, 95% CI = 1.00–1.82 and OR = 0.94, 95% CI = 0.69–1.28, respectively). At ages 13–14 years, the strongest associations at the individual level were with current paracetamol use (OR = 1.57, 95% CI = 1.51–1.63) and open-fire cooking (OR = 1.46, 95% CI = 1.33–1.62); both were stronger at the school level (OR = 2.57, 95% CI = 1.84–3.59 and OR = 2.38, 95% CI = 1.52–3.73, respectively). Association with exposure to heavy traffic (OR = 1.31, 95% CI = 1.27–1.36) also persisted at the school level (OR = 1.40, 95% CI = 1.07–1.82). Most individual- and school-level effects were consistent, tending to exclude reverse causation.
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  • Maternal post-natal tobacco use and current parental tobacco use is associated with higher body mass index in children and adolescents: an international cross-sectional study.

    Braithwaite, Irene; Stewart, Alistair W; Hancox, Robert J; Beasley, Richard; Murphy, Rinki; Mitchell, Edwin A; Chiarella, Pascual; ISAAC Phase Three Study Group; irene.braithwaite@mrinz.ac.nz (BioMed Central Ltd., 2015-12-24)
    Background: We investigated whether maternal smoking in the first year of life or any current parental smoking is associated with childhood or adolescent body mass index (BMI). Methods: Secondary analysis of data from a multi-centre, multi-country, cross-sectional study (ISAAC Phase Three). Parents/guardians of children aged 6-7 years completed questionnaires about their children's current height and weight, whether their mother smoked in the first year of the child's life and current smoking habits of both parents. Adolescents aged 13-14 years completed questionnaires about their height, weight and current parental smoking habits. A general linear mixed model was used to determine the association between BMI and parental smoking. Results: 77,192 children (18 countries) and 194 727 adolescents (35 countries) were included. The BMI of children exposed to maternal smoking during their first year of life was 0.11 kg/m 2 greater than those who were not (P = 0.0033). The BMI of children of currently smoking parents was greater than those with non-smoking parents (maternal smoking: +0.08 kg/m 2 (P = 0.0131), paternal smoking: +0.10 kg/m 2 (P < 0.0001)). The BMI of female adolescents exposed to maternal or paternal smoking was 0.23 kg/m 2 and 0.09 kg/m 2 greater respectively than those who were not exposed (P < 0.0001). The BMI of male adolescents was greater with maternal smoking exposure, but not paternal smoking (0.19 kg/m 2 , P < 0.0001 and 0.03 kg/m 2 , P = 0.14 respectively). Conclusion: Parental smoking is associated with higher BMI values in children and adolescents. Whether this is due to a direct effect of parental smoking or to confounding cannot be established from this observational study.
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  • Over 675,000 lay people trained in cardiopulmonary resuscitation worldwide - The "World Restart a Heart (WRAH)" initiative 2018.

    Böttiger, B W; Lockey, A; Aickin, R; Bertaut, T; Castren, M; de Caen, A; Censullo, E; Escalante, R; Gent, L; Georgiou, M; Kern, K B; Khan, A M S; Lim, S H; Nadkarni, V; Nation, K; Neumar, R W; Nolan, J P; Rao, S S C C; Stanton, D; Toporas, C; Wang, T-L; Wong, G; Perkins, G D (Elsevier Ireland Ltd, 2019-05-01)
    Cartas al editor
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  • Comments on the Study "The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and Its Associated Factors"

    Poletti-Jabbour, G.; Elejalde-Farfán, N.; giordi_poletti@hotmail.com (NLM (Medline), 2019-03-14)
    Comments were made on the article “The Sensitivity, Specificity and Accuracy of Warning Signs in Predicting Severe Dengue, the Severe Dengue Prevalence and Its Associated Factors” found in the journal “International Journal of Environmental Research and Public Health” based on the CASP Checklist’s guide for the assessment of diagnostic tests.
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  • Nosocomial infections increase the length of hospital stay

    Carpio-Zevallos, Marcelo Sebastián; Sobrado-Jara, Katherine Susana; Carreazo, Nilton Yhuri (Elsevier Ltd, 2019-04-30)
    Cartas al editor
    Acceso restringido temporalmente
  • Migration crisis in Venezuela: impact on HIV in Peru

    Rebolledo-Ponietsky, K; Munayco, C V; Mezones-Holguín, E; kirbeliz1609@gmail.com (Oxford University Press, 2019-02-01)
    Cartas al editor
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  • Is manual therapy based on neurodynamic techniques effective in the treatment of carpal tunnel syndrome? A randomized controlled trial.

    Miranda-Medina, José; Cavigiolo, Mateo Barba; Soto, Alonso; Wolny, T; Linek, Pawel (SAGE Publications Ltd, 2019-01-28)
    Cartas al editor
    Acceso restringido temporalmente
  • Risk of community-acquired pneumonia in older adults with sarcopenia of a hospital from Callao, Peru 2010–2015

    Altuna-Venegas, Sofia; Aliaga-Vega, Raul; Maguiña, Jorge L.; Parodi, Jose F.; Runzer-Colmenares, Fernando M. (Elsevier Ireland Ltd, 2019-06)
    Introduction: Sarcopenia is a geriatric syndrome characterized by loss of muscle mass and strength. The prevalence in people between 60–70 years is about 5–13% and in adults over 80 years, between 11–50% in the USA. Sarcopenia increases the risk of mortality and nosocomial infections. Community-acquired pneumonia is the first infectious-related cause of death in elderly people. However, there is lack of evidence about the association between sarcopenia and pneumonia. The aim of our study was to determine the incidence and risk factors of community-acquired pneumonia in older adults with sarcopenia in a Peruvian hospital. Methods: A retrospective cohort study was conducted in the geriatrics service of Centro Medico Naval “Cirujano Mayor Santiago Tavara”. Sarcopenia was defined by “European Consensus of Sarcopenia” criteria. MultivariatePoisson regression model was conducted to estimate the effect of the independent association between sarcopenia and pneumonia. Results: A total of 1598 subjects were enrolled, 59.0% were male; with a mean age of 78.3 ± 8.6 years. The prevalence of sarcopenia was 15.1% (95% CI: 13.3–16.8) and the incidence of community-acquired pneumonia was 15.14% (95%CI 13.4–16.9). In the multivariate model, we found a higher incidence of pneumonia in sarcopenic compared to non-sarcopenic, RR(a) 3.88 (95% CI: 2.82–5.33). Discussion: Our study showed a higher incidence of community-acquired pneumonia in sarcopenic subject. Results provide information on the importance of detecting this syndrome because it gives us scientific evidence of the interest of a correct comprehensive geriatric assessment in older patients with a high risk of pneumonia.
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  • Dengue diagnosis in an endemic area of Peru: Clinical characteristics and positive frequencies by RT-PCR and serology for NS1, IgM, and IgG

    Palomares-Reyes, Carlos; Silva-Caso, Wilmer; del Valle, Luis J.; Aguilar-Luis, Miguel Angel; Weilg, Claudia; Martins-Luna, Johanna; Viñas-Ospino, Adriana; Stimmler, Luciana; Mallqui Espinoza, Naysha; Aquino Ortega, Ronald; Espinoza Espíritu, Walter; Misaico, Erika; del Valle-Mendoza, Juana; juana.delvalle@upc.pe (Elsevier B.V., 2019-04)
    Background: Huánuco is a central eastern region of Peru whose geography includes high forest and low jungle, as well as a mountain range that constitutes the inter-Andean valleys. It is considered a region endemic for dengue due to the many favorable conditions that facilitate transmission of the virus. Methods: A total of 268 serum samples from patients in Huánuco, Peru with an acute febrile illness were assessed for the presence of dengue virus (DENV) via RT-PCR and NS1, IgM, and IgG ELISA during December 2015 and March 2016. Results: DENV was detected in 25% of samples via RT-PCR, 19% of samples by NS1 antigen ELISA, and 10.5% of samples by IgM ELISA. DENV IgG was detected in 15.7% of samples by ELISA. The most frequent symptoms associated with fever across all groups were headache, myalgia, and arthralgia, with no significant difference between the four test methods Conclusions: In this study, DENV was identified in up to 25% of the samples using the standard laboratory method. In addition, a correlation was established between the frequency of positive results and the serological tests that determine NS1, IgM, and IgG. There is an increasing need for point-of-care tests to strengthen epidemiological surveillance in Peru.
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  • Association between social media use (Twitter, Instagram, Facebook) and depressive symptoms: Are Twitter users at higher risk?

    Jeri-Yabar, Antoine; Sanchez-Carbonel, Alejandra; Tito, Karen; Ramirez-delCastillo, Jimena; Torres-Alcantara, Alessandra; Denegri, Daniela; Carreazo, Nilton Yhuri (SAGE Publications Ltd, 2019-02)
    Background: The purpose of this study was to determine the association between social media dependence and depressive symptoms and also, to characterize the level of dependence. It was a transversal, analytical research. Subjects and Methods: The stratified sample was 212 students from a private university that used Facebook, Instagram and/or Twitter. To measure depressive symptoms, Beck Depression Inventory was used, and to measure the dependence to social media, the Social Media Addiction Test was used, adapted from the Internet Addiction Test of Echeburúa. The collected data were subjected for analysis by descriptive statistics where STATA12 was used. Results: The results show that there is an association between social media dependence and depressive symptoms (PR [Prevalence Ratio] = 2.87, CI [Confidence Interval] 2.03–4.07). It was also shown that preferring the use of Twitter (PR = 1.84, CI 1.21–2.82) over Instagram (PR = 1.61, CI 1.13–2.28) is associated with depressive symptoms when compared to the use of Facebook. Conclusion: Excessive social media use is associated with depressive symptoms in university students, being more prominent in those who prefer the use of Twitter over Facebook and Instagram.
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  • Comment on: Tools Measuring Quality of Death, Dying, and Care, Completed After Death: Systematic Review of Psychometric Properties

    Montoya-Medina, José E.; Poletti-Jabbour, Giordana; Urrunaga, Nicole; Jiménez, Heyson A.; jmontoyam96@gmail.com; yhuroc@gmail.com (Springer International Publishing, 2019-02)
    Cartas al editor.
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  • Association of antepartum suicidal ideation during the third trimester with infant birth weight and gestational age at delivery

    Gelaye, Bizu; Domingue, Amber; Rebelo, Fernanda; Friedman, Lauren E; Qiu, Chunfang; Sanchez, Sixto E; Larrabure-Torrealva, Gloria; Williams, Michelle A; bgelaye@hsph.harvard.edu (Routledge, 2019-02)
    Antepartum suicidal behaviors are a leading cause of maternal injury and death. Previous research has not investigated associations between antepartum suicidal ideation and perinatal complications. Our study objective was to evaluate the relationship of antepartum suicidal ideation with low infant birthweight, small for gestational age, and preterm birth. A cohort study was conducted among 1,108 women receiving prenatal care in Peru. Suicidal ideation was measured using the Patient Health Questionnaire-9 during pregnancy. Birth outcomes were extracted from medical records. Linear regressions and multivariable logistic regressions were used to estimate were used to investigate associations between suicidal ideation and pregnancy outcomes. The prevalence of suicidal ideation was 8.7%, preterm delivery was 5.7%, low birthweight was 4.4%, and small for gestational age was 3.4%. In an adjusted model, infant birthweight was 94.2 grams lower for mothers with antepartum suicidal ideation (95% CI: −183.0, −5.5, p = 0.037) compared with those without suicidal ideation. After adjusting for confounders including depression, participants with suicidal ideation had a nearly four-fold increased odds of delivering a small for gestational age infant (OR: 3.73; 95% CI: 1.59–8.74). These findings suggest suicidal ideation during pregnancy is associated with adverse perinatal outcomes, especially low infant birthweight.
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  • Comments on “Affective instability in those with and without mental disorders: A case control study” by Marwaha et al.

    Cornejo-Rojas, Diego A; Castillo-Soto, Ana; Araujo-Castillo, Roger V; diegocr96@gmail.com (Elsevier B.V., 2019-03)
    This letter has the purpose to comment the article by Marwaha et al. regarding affective instability and mental disorders. We wish to highlight the importance to report the proper measures of association in case-control studies, and the impact of adjusting the results when finding associations with possible confounders in the bivariate analysis.
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  • Diagnosis of erectile dysfunction can be used to improve screening for Type 2 diabetes mellitus

    Carrillo Larco, RM; Luza Dueñas, A.C; Urdániga Hung, M.c; Bernabé Ortiz, A (Blackwell Publishing Ltd, 2018-11)
    Aims: To assess the diagnostic accuracy of four undiagnosed Type 2 diabetes mellitus risk scores accounting for erectile dysfunction status. Methods: This was a population-based cross-sectional study. Type 2 diabetes was defined according to a oral glucose tolerance test and self-reported physician diagnosis. Erectile dysfunction was defined according to the answer to the question, ‘Have you had difficulties obtaining an erection in the last 6 months?’ (yes/no). The risk scores used were the FINDRISC, LA-FINDRISC, American Diabetes Association score and the Peruvian Risk Score. A Poisson regression model was fitted to assess the association between Type 2 diabetes and erectile dysfunction. The area under the receiver-operating characteristic curve was estimated overall and by erectile dysfunction status. Results: A total of 799 men with a mean (sd) age of 48.6 (10.7) years were included in the study. The overall prevalence of Type 2 diabetes was 9.3%. Compared with healthy men, men with Type 2 diabetes had 2.71 (95% CI 1.57–4.66) higher chances of having erectile dysfunction. Having excluded men aware of Type 2 diabetes status (N=38), the area under the receiver-operating characteristic curve of three of the risk scores (not the American Diabetes Association score) improved among those who had erectile dysfunction in comparison with those who did not; for example, the area under the receiver-operating characteristic curve of the LA-FINDRISC score was 89.6 (95% CI 78.7–99.9) in men with erectile dysfunction and 76.5 (95% CI 68.5–84.4) overall. Conclusions: In a population-based study, erectile dysfunction was more common in men with Type 2 diabetes than in the otherwise healthy men. Screening for erectile dysfunction before screening for Type 2 diabetes seems to improve the accuracy of well-known risk scores for undiagnosed Type 2 diabetes.
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  • Bioimpedance markers and tuberculosis outcome among HIV-infected patients

    Montalvo, R; Bernabe Ortiz, A; Kirwan, D; Gilman, R; otivo3@hotmail.com (Obafemi Awolowo University, 2018)
    ackground: The changes in body composition markers (weight, fat mass, lean mass, and BMI) over time can be associated with TB treatment outcome among HIV-infected patients. The aim of this study was to investigate whether changes in fat mass and lean mass were associated with the treatment response among patients with HIV infection and pulmonary tuberculosis. Materials and Methods: This was a prospective cohort study. Data from HIV-infected patients commencing TB therapy were analyzed. This included body weight measurement using bioimpedance equipment at baseline, one month, and two months after starting TB treatment. Results: The study was conducted in 125 patients, 17 patients (13.6%) died during treatment, of which 5 died during the first month of treatment, 4 during the second month and 8 after the second month. The group of patients with good response, increased their weight by 1.3 kg (p <0.001) at the end of the first month of TB treatment and 2.6 kg in the second month (p <0.001), and body fat increase was 1.2 Kg (p <0.001) and 2.3 kg (p <0.001), the first and second month respectively. The group of patients who died had lost 2.1 kg fat mass after the first month (p <0.001) and 3.7 kg in the second month (p <0.001). Conclusions: Our results show that the weight change during TB treatment (increased fat mass) helps us predict therapeutic response. Weight loss during the first month of starting therapy should be evaluated thoroughly to identify the probable cause of treatment failure.
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  • Síndrome metabólico en pacientes con infección por VIH: ¿oportunidad para la suplementación nutricional?

    Valdivia-Caramantín, Wendy; Mezones-Holguín, Edward; michellvc@gmail.com (Sociedad Chilena de Infectologia, 2018)
    “Cartas al editor”
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  • Estrategia de uno en uno para mejorar la técnica correcta de higiene de manos

    Carpio Rodríguez, A; Mercado Gonzáles, S; sofimg2311@gmail.com (Instituto Nacional de Pediatria, 2018-01)
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