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  • Prevalence of asthma symptoms in Latin America: the International Study of Asthma and Allergies in Childhood (ISAAC).

    Mallol, J; Solé, D; Asher, I; Clayton, T; Stein, R; Soto-Quiroz, M; jmallol@lauca.usach.cl (John Wiley & Sons, 2000-12-01)
    The prevalence of respiratory symptoms indicative of asthma in children from Latin America has been largely ignored. As part of the International Study of Asthma and Allergies in Childhood (ISAAC), 17 centers in 9 different Latin American countries participated in the study, and data from 52,549 written questionnaires (WQ) in children aged 13-14 years and from 36,264 WQ in 6-7 year olds are described here. In children aged 13-14 years, the prevalence of asthma ever ranged from 5.5-28%, and the prevalence of wheezing in the last 12 months from 6.6-27%. In children aged 6-7 years, the prevalence of asthma ever ranged from 4.1-26.9%, and the prevalence of wheezing in the last 12 months ranged from 8.6-32.1%. The lower prevalence in centers with higher levels of atmospheric pollution suggests that chronic inhalation of polluted air in children does not contribute to asthma. Furthermore, the high figures for asthma in a region with a high level of gastrointestinal parasite infestation, and a high burden of acute respiratory infections occurring early in life, suggest that these factors, considered as protective in other regions, do not have the same effect in this region. The present study indicates that the prevalence of asthma and related symptoms in Latin America is as high and variable as described in industrialized or developed regions of the world.
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  • Asthma control in Latin America: the Asthma Insights and Reality in Latin America (AIRLA) survey.

    Neffen, Hugo; Fritscher, Carlos; Schacht, Francisco Cuevas; Levy, Gur; Chiarella, Pascual; Soriano, Joan B; Mechali, Daniel; Daniel.G.Mechali@gsk.com (Pan American Health Organization, 2005-03-01)
    Objectives. The aims of this survey were (1) to assess the quality of asthma treatment and control in Latin America, (2) to determine how closely asthma management guidelines are being followed, and (3) to assess perception, knowledge and attitudes related to asthma in Latin America. Methods. We surveyed a household sample of 2 184 adults or parents of children with asthma in 2003 in 11 countries in Latin America. Respondents were asked about healthcare utilization, symptom severity, activity limitations and medication use. Results. Daytime asthma symptoms were reported by 56% of the respondents, and 51 % reported being awakened by their asthma at night. More than half of those surveyed had been hospitalized, attended a hospital emergency service or made unscheduled emergency visits to other healthcare facilities for asthma during the previous year. Patient perception of asthma control did not match symptom severity, even in patients with severe persistent asthma, 44.7% of whom regarded their disease as being well or completely controlled. Only 2.4% (2.3% adults and 2.6% children) met all criteria for asthma control. Although 37% reported treatment with prescription medications, only 6% were using inhaled corticosteroids. Most adults (79%) and children (68%) in this survey reported that asthma symptoms limited their activities. Absence from school and work was reported by 58% of the children and 31% of adults, respectively. Conclusions. Asthma control in Latin America falls short of goals in international guidelines, and in many aspects asthma care and control in Latin America suffer from the same shortcomings as in other areas of the world.
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  • The International Study of Wheezing in Infants: questionnaire validation.

    Mallol, Javier; García-Marcos, Luis; Aguirre, Viviana; Martinez-Torres, Antonela; Perez-Fernández, Virginia; Gallardo, Alejandro; Calvo, Mario; Rosario Filho, Nelson; Rocha, Wilson; Fischer, Gilberto; Baeza-Bacab, Manuel; Chiarella, Pascual; Pinto, Rosario; Barria, Claudio; jmallol@usach.cl (Karger AG, Basel, 2007-01-01)
    Background: There are no internationally validated questionnaires to investigate the prevalence of infant wheezing. This study was undertaken to validate a questionnaire for the International Study on the Prevalence of Wheezing in Infants (Estudio Internacional de Sibilancias en Lactantes, EISL). Material and Methods: Construct and criterion validity were tested for the question 'Has your baby had wheezing or whistling in the chest during his/her first 12 months of life?'. Construct validity (i.e. the ability of parents and doctors to refer to the same symptoms with the same words) was tested in a sample of 50 wheezing and 50 non-wheezy infants 12-15 months of age in each of 10 centres from 6 different Spanish- or Portuguese-speaking countries. Criterion validity (i.e. the ability of parents to correctly detect the symptom in the general population) was evaluated in 2 samples (Santiago, Chile and Cartagena, Spain) of 50 wheezing and 50 non-wheezing infants (according to parents) of the same age, randomly selected from the general population, who were later blindly diagnosed by a paediatric pulmonologist. Results: Construct validity was very high (κ test: 0.98-1) in all centres. According to Youden's index, criterion validity was good both in Cartagena (75.5%) and in Santiago (67.0%). Adding questions about asthma medication did not improve diagnosis accuracy. Conclusions: The EISL questionnaire significantly distinguished wheezy infants from healthy ones. This questionnaire has a strong validity and can be employed in large international multicentre studies on wheezing during infancy.
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  • Global variations in prevalence of eczema symptoms in children from ISAAC Phase Three.

    Odhiambo, Joseph A; Williams, Hywel C; Clayton, Tadd O; Robertson, Colin F; Asher, M Innes; Chiarella, Pascual; ISAAC Phase Three Study Group.; t.clayton@auckland.ac.nz (Mosby Inc., 2009-12-01)
    Background: In 1999, The International Study of Asthma and Allergies in Childhood (ISAAC) Phase One reported the prevalence of eczema symptoms in 715,033 children from 154 centers in 56 countries by using standardized epidemiologic tools. Objective: To update the world map of eczema prevalence after 5 to 10 years (ISAAC Phase Three) and include additional data from over 100 new centers. Methods: Cross-sectional surveys using the ISAAC questionnaire on eczema symptoms were completed by adolescents 13 to 14 years old and by parents of children 6 to 7 years old. Current eczema was defined as an itchy flexural rash in the past 12 months and was considered severe eczema if associated with 1 or more nights per week of sleep disturbance. Results: For the age group 6 to 7 years, data on 385,853 participants from 143 centers in 60 countries showed that the prevalence of current eczema ranged from 0.9% in India to 22.5% in Ecuador, with new data showing high values in Asia and Latin America. For the age group 13 to 14 years, data on 663,256 participants from 230 centers in 96 countries showed prevalence values ranging from 0.2% in China to 24.6% in Columbia with the highest values in Africa and Latin America. Current eczema was lower for boys than girls (odds ratio, 0.94 and 0.72 at ages 6 to 7 years and 13 to 14 years, respectively). Conclusion:ISAAC Phase Three provides comprehensive global data on the prevalence of eczema symptoms that is essential for public health planning. New data reveal that eczema is a disease of developing as well as developed countries.
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  • The impact of the method of consent on response rates in the ISAAC time trends study.

    Ellwood, P; Asher, M I; Stewart, A W; Chiarella, Pacual; ISAAC Phase III Study Group; p.ellwood@auckland.ac.nz (nternational Union against Tubercul. and Lung Dis., 2010-08-01)
    BACKGROUND: Centres in Phases I and III of the International Study of Asthma and Allergies in Childhood (ISAAC) programme used the method of consent (passive or active) required by local ethics committees. METHODS: Retrospectively, relationships between achieved response rates and method of consent for 13-14 and 6-7-year-olds (adolescents and children, respectively), were examined between phases and between English and non-English language centres. RESULTS: Information was obtained for 113 of 115 centres for adolescents and 72/72 centres for children. Both age groups: most centres using passive consent achieved high response rates (>80% adolescents and >70% children). English language centres using active consent showed a larger decrease in response rate. Adolescents: seven centres changed from passive consent in Phase I to active consent in Phase III (median decrease of 13%), with five centres showing lower response rates (as low as 34%). Children: no centre changed consent method between phases. Centres using active consent had lower median response rates (lowest response rate 45%). CONCLUSION: The requirement for active consent for population school-based questionnaire studies can impact negatively on response rates, particularly English language centres, thus adversely affecting the validity of the data. Ethics committees need to consider this issue carefully.
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  • Which population level environmental factors are associated with asthma, rhinoconjunctivitis and eczema? Review of the ecological analyses of ISAAC Phase One.

    Asher, M Innes; Stewart, Alistair W; Mallol, Javier; Montefort, Stephen; Lai, Christopher K W; Aït-Khaled, Nadia; Odhiambo, Joseph; Chiarella, Pascual; The ISAAC Phase One Study Group; mi.asher@auckland.ac.nz (2010-01-21)
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  • Asthma and Rhinitis in South America: How Different They are From Other Parts of the World.

    Chong Neto, Herberto José; Rosário, Nelson Augusto; Solé, Dirceu; Chiarella, Pascual; Latin American ISAAC Study Group; nelson.rosario@ufpr.br (Korean Academy of Asthma, Allergy and Clinical Immunology and the Korean Academy of Pediatric Allergy and Respiratory Disease, 2012-03-01)
    Asthma and rhinitis epidemiology has wide variations around the world. The aim of this review was verify the prevalence of asthma and rhinitis in South America and report differences from other regions of the world. We reviewed studies with International Study of Asthma and Allergies in Childhood (ISAAC) methodology in South America, Phases I and III. In South America the ISAAC Phase I ranked four countries among top ten in prevalence of asthma and three countries among top ten in prevalence of rhinoconjunctivitis. ISAAC Phase III showed little changes in asthma and rhinitis prevalence in South American countries. The prevalence increases of asthma and rhinitis in South American centers indicate that the burden of both is continuing to rise, but the differences in prevalence are lessening.
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  • 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
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  • 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
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  • 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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