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  • Association Between Procrastination And Academic Stress In Peruvian Second-Year Medical Students

    León, Eduardo Orco; Saldívar, Daphne Huamán; Rodríguez, Susel Ramírez; Torreblanca, Jonathan Torres; Salvador, Linder Figueroa; Mejia, Christian R.; Reyes, Ibraín Enrique Corrales (Editorial Ciencias Medicas, 2022-01-01)
    Introduction: University medical students are a population exposed to a high academic load, high level of exigency, high demand of time and there are factors that can affect the effectiveness of academic performance, such as stress and procrastination. Objective: Evaluate the association between stress and procrastination in a pilot sample of medical students at a university in Lima, Peru. Material and methods: A cross-sectional analytical study was conducted, where medical students from the Research Methodology course were recruited at a university in the Peruvian capital. In them, stress and procrastination were measured, both with previously validated tests, then these variables were related and adjusted according to their sex and age. For analytical statistics, generalized linear models were used and p-values ≤ 0.05 were considered statistically significant. Results: When performing the multivariate analysis, it was found that there was a relationship between procrastination and male gender (p = 0.001), age (p = 0.035) and stress (p = 0.022) of the respondents. Conclusions: Procrastination maintains in the sample studied an important association with the stress that students have, as well as with their gender and age.
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  • Does Breast-Conserving Surgery with Radiotherapy have a Better Survival than Mastectomy? A Meta-Analysis of More than 1,500,000 Patients

    De la Cruz Ku, Gabriel; Karamchandani, Manish; Chambergo-Michilot, Diego; Narvaez-Rojas, Alexis R.; Jonczyk, Michael; Príncipe-Meneses, Fortunato S.; Posawatz, David; Nardello, Salvatore; Chatterjee, Abhishek (Springer Science and Business Media Deutschland GmbH, 2022-01-01)
    Background: There have been conflicting studies reporting on survival advantages between breast-conserving surgery with radiotherapy (BCS) in comparison with mastectomy. Our aim was to compare the efficacy of BCS and mastectomy in terms of overall survival (OS) comparing all past published studies. Methods: We performed a comprehensive review of literature through October 2021 in PubMed, Scopus, and EMBASE. The studies included were randomized controlled trials (RCTs) and cohorts that compare BCS versus mastectomy. We excluded studies that included male sex, stage 0, distant metastasis at diagnosis, bilateral synchronous cancer, neoadjuvant radiation/chemotherapy, and articles with incomplete data. We performed a meta-analysis following the random-effect model with the inverse variance method. Results: From 18,997 publications, a total of 30 studies were included in the final analysis: 6 studies were randomized trials, and 24 were retrospective cohorts. A total of 1,802,128 patients with a follow-up ranging from 4 to 20 years were included, and 1,075,563 and 744,565 underwent BCS and mastectomy, respectively. Among the population, BCS is associated with improved OS compared with mastectomy [relative risk (RR) 0.64, 95% confidence interval (CI) 0.55–0.74]. This effect was similar when analysis was performed in cohorts and multi-institutional databases (RR 0.57, 95% CI 0.49–0.67). Furthermore, the benefit of BCS was stronger in patients who had less than 10 years of follow-up (RR 0.54, 95% CI 0.46–0.64). Conclusions: Patients who underwent BCS had better OS compared with mastectomy. Such results depicting survival advantage, especially using such a large sample of patients, may need to be included in the shared surgical decision making when discussing breast cancer treatment with patients.
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  • Identifying RO9021 as a Potential Inhibitor of PknG from Mycobacterium tuberculosis: Combinative Computational and in Vitro Studies

    Arica-Sosa, Alicia; Alcántara, Roberto; Jiménez-Avalos, Gabriel; Zimic, Mirko; Milón, Pohl; Quiliano, Miguel (American Chemical Society, 2022-06-14)
    Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis (Mtb). Despite being considered curable and preventable, the increase of antibiotic resistance is becoming a serious public health problem. Mtb is a pathogen capable of surviving in macrophages, causing long-Term latent infection where the mycobacterial serine/threonine protein kinase G (PknG) plays a protective role. Therefore, PknG is an important inhibitory target to prevent Mtb from entering the latency stage. In this study, we use a pharmacophore-based virtual screening and biochemical assays to identify the compound RO9021 (CHEMBL3237561) as a PknG inhibitor. In detail, 1.5 million molecules were screened using a scalable cloud-based setup, identifying 689 candidates, which were further subjected to additional screening employing molecular docking. Molecular docking spotted 62 compounds with estimated binding affinities of-7.54 kcal/mol (s.d. = 0.77 kcal/mol). Finally, 14 compounds were selected for in vitro experiments considering previously reported biological activities and commercial availability. In vitro assays of PknG activity showed that RO9021 inhibits the kinase activity similarly to AX20017, a known inhibitor. The inhibitory effect was found to be dose dependent with a relative IC50value of 4.4 ± 1.1 μM. Molecular dynamics simulations predicted that the PknG-RO9021 complex is stable along the tested timescale. Altogether, our study indicates that RO9021 is a noteworthy drug candidate for further developing new anti-TB drugs that hold excellent reported pharmacokinetic parameters.
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  • Association between time of residence and self-perception of distress, interpersonal relationships, and social role in Venezuelan immigrants in Lima, Peru 2018–19: mixed-methods study

    Delgado-Cáceres, Frank Milton; Silva-Parra, Kevin Angel; Torres-Slimming, Paola A. (BioMed Central Ltd, 2022-12-01)
    Background: Immigrants arriving in a new country face changes that affect their social, employment, and migratory status. We carried out a mixed-methods study in the rapidly growing Venezuelan immigrant population in Lima, Peru. The objective was to determine whether there was an association between time in Peru and self-perception of symptom distress (SD), interpersonal relationships (IR), and social role (SR). Methods: The quantitative central component consisted of a cross-sectional study, surveying 152 participants using the Outcome Questionnaire 45.2 (OQ-45.2). The qualitative component, based on phenomenology, explored experiences and challenges during the migration process. Semi-structured in-depth interviews were conducted in 16 informants. Results: An association that was observed was the increase in the risk of clinically significant SR score with additional years of age. All informants mentioned having witnessed or experienced xenophobia in Peru. Every informant stated that significant labor differences existed between the countries. The most reported somatic symptoms were symptoms of anxiety and alterations of sleep. Additionally, no informant expressed a desire to remain in Peru long term. Conclusions: A minority of participants registered a clinically significant total score and in each of the three domains of SD, IR, and SR. No association between months in Lima and the self-perception of distress was found. However, this could be due to the short amount of time spent in Peru and any change in self-perception might only be perceived after years or decades spent in Peru. This study is one of the first to use mixed-methods to explore the mental health of the immigrant Venezuelan population.
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  • Prognostic value of albumin-to-globulin ratio in COVID-19 patients: A systematic review and meta-analysis

    Ulloque-Badaracco, Juan R.; Mosquera-Rojas, Melany D.; Hernandez-Bustamante, Enrique A.; Alarcón-Braga, Esteban A.; Herrera-Añazco, Percy; Benites-Zapata, Vicente A. (Elsevier Ltd, 2022-05-01)
    Background and aims: The albumin-to-globulin ratio (AGR) has been used to predict severity and mortality in infectious diseases. The aim of this study is to evaluate the prognostic value of the AGR in COVID-19 patients. Methods: A systematic review and meta-analysis were conducted. We included observational studies assessing the association between the AGR values upon hospital admission and severity or all-cause mortality in COVID-19 patients. In the meta-analyses we used random effect models. Risk of bias was assessed using the Newcastle-Ottawa Scale (NOS). The effect measures were expressed as mean difference (MD) and their 95% confidence intervals (CI). We performed Egger's test and funnel plots to assess the publication bias. Results: The included studies had a total of 11356 patients corresponding to 31 cohort studies. Severe COVID-19 patients had lower AGR values than non-severe COVID-19 patients (mean difference (MD), −0.27; 95% IC, −0.32 to −0.22; p < 0.001; I2 = 88%). Non-survivor patients with COVID-19 had lower AGR values than survivor patients (MD, −0.29; 95% IC, −0.35 to −0.24; p < 0.001; I2 = 79%). In the sensitivity analysis, we only included studies with low risk of bias, which decreased the heterogeneity for both outcomes (severity, I2 = 20%; mortality, I2 = 5%). Conclusions: Low AGR values upon hospital admission were found in COVID-19 patients with a worse prognosis.
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  • Consumption of Herbal Supplements or Homeopathic Remedies to Prevent COVID-19 and Intention of Vaccination for COVID-19 in Latin America and the Caribbean

    Bendezu-Quispe, Guido; Benites-Meza, Jerry K.; Urrunaga-Pastor, Diego; Herrera-Añazco, Percy; Uyen-Cateriano, Angela; Rodriguez-Morales, Alfonso J.; Toro-Huamanchumo, Carlos J.; Hernandez, Adrian V.; Benites-Zapata, Vicente A. (MDPI, 2022-06-01)
    Users of complementary and alternative medicine (CAM) have a lower intention to receive vaccines. Furthermore, Latin America and the Caribbean (LAC) region are among the most affected areas by the COVID-19 pandemics and present a high proportion of CAM users. Therefore, this study evaluates the association between the consumption of herbal supplements or homeopathic remedies to prevent COVID-19 and the intention to vaccinate against COVID-19 in the LAC region. We conducted a secondary data analysis of a Massachusetts Institute of Technology (MIT) survey with Facebook to assess COVID-19 beliefs, behaviours, and norms. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated using generalized linear models of the Poisson family with the log link function. The prevalence of the use of products to prevent COVID-19 was the following: consumption of herbal supplements (7.2%), use of homeopathic remedies (4.8%), and consumption of garlic, ginger, and lemon (11.8%). An association was found between using herbal supplements (19.0% vs. 12.8%; aPR = 1.44; 95% CI: 1.30–1.58), the use of homeopathic remedies (20.3% vs. 12.3%; aPR = 1.58; 95% CI: 1.25–1.98), and the consumption of garlic, ginger, and lemon (18.9% vs. 11.9%; aPR = 1.55; 95% CI: 1.50–1.61) and non-intention to vaccinate against COVID-19. In the LAC population, there is an association between using herbal supplements, using homeopathic remedies and consuming garlic, ginger, and lemon to prevent infection by COVID-19 and non-intention to vaccinate against this disease. Therefore, it is necessary to design targeted strategies for groups that consume these products as preventive measures against COVID-19 to increase vaccination coverage and expand the information regarding transmission and prevention strategies for SARS-CoV-2.
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  • GC-MS Profile, Antioxidant Activity, and in Silico Study of the Essential Oil from Schinus molle L. Leaves in the Presence of Mosquito Juvenile Hormone-Binding Protein (mJHBP) from Aedes aegypti

    Herrera-Calderon, Oscar; Chavez, Haydee; Enciso-Roca, Edwin Carlos; Común-Ventura, Pablo Williams; Hañari-Quispe, Renan Dilton; Figueroa-Salvador, Linder; Loyola-Gonzales, Eddie Loyola; Pari-Olarte, Josefa Bertha; Aljarba, Nada H.; Alkahtani, Saad; Batiha, Gaber El Saber (Hindawi Limited, 2022-01-01)
    Schinus molle is a medicinal plant used as an anti-inflammatory and for rheumatic pain in the traditional medicine of Peru. On the other hand, Aedes aegypti is the main vector of several tropical diseases and the transmitter of yellow fever, chikungunya, malaria, dengue, and Zika virus. In this study, the aim was to investigate the antioxidant activity in vitro and the insecticidal activity in silico, in the presence of the mosquito juvenile hormone-binding protein (mJHBP) from Aedes aegypti, of the essential oil from S. molle leaves. The volatile phytochemicals were analyzed by gas chromatography-mass spectrometry (GC-MS), and the profile antioxidants were examined by DPPH, ABTS, and FRAP assays. The evaluation in silico was carried out on mJHBP (PDB: 5V13) with an insecticidal approach. The results revealed that EO presented as the main volatile components to alpha-phellandrene (32.68%), D-limonene (12.59%), and beta-phellandrene (12.24%). The antioxidant activity showed values for DPPH=11.42±0.08 μmol ET/g, ABTS=134.88±4.37 μmol ET/g, and FRAP=65.16±1.46 μmol ET/g. Regarding the insecticidal approach in silico, alpha-muurolene and gamma-cadinene had the best biding energy on mJHBP (ΔG=-9.7 kcal/mol), followed by beta-cadinene (ΔG=-9.5 kcal/mol). Additionally, the volatile components did not reveal antioxidant activity, and its potential insecticidal effect would be acting on mJHBP from A. aegypti.
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  • Neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio as risk factors for mortality in Peruvian adults with chronic kidney disease

    Umeres-Francia, Gianfranco Eddú; Rojas-Fernández, María Valentina; Herrera-Añazco, Percy; Benites-Zapata, Vicente Aleixandre (BioMed Central Ltd, 2022-12-01)
    Objective: To assess the association between the neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) with all-cause mortality in Peruvian patients with chronic kidney disease (CKD) attending a tertiary hospital. Methods: We conducted a retrospective cohort study in adults with CKD in stages 1–5. The outcome variable was mortality and as variables of exposure to NLR and PLR. Both ratios were categorized as high with a cutoff point of 3.5 and 232.5, respectively. We carried out a Cox regression model and calculated crude and adjusted hazard ratios (HR) with their 95% confidence interval (95% CI). Results: We analyzed 343 participants with a mean age of 78.3 (± 11.9) years and 62.9% (n = 216) men. The median follow-up time was 2.45 years (2.08–3.08), and the frequency of deaths was 17.5% (n = 60). The mortality of patients with high NLR was 28% compared to 15.7% of the group with normal NLR, and the mortality was 35.7% in those with high PLR and 15.6% in those with normal PLR. In the crude analysis, the high NLR and PLR were significantly associated with all-cause mortality (HR = 2.01; 95% CI 1.11–3.66) and (HR = 2.58; 95% CI 1.31–5.20). In the multivariate model, after adjusting for age, sex, serum creatinine, albumin and hemoglobin, the high NLR and PLR remained as independent risk factors for all-cause mortality (aHR = 1.97; 95% CI 1.05–3.69) and (aHR = 2.62; 95% CI 1.25–5.51), respectively. Conclusion: Our study suggests the relationship between high NLR and PLR with all-cause mortality in patients with CKD.
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  • Acceptance towards COVID-19 vaccination in Latin America and the Caribbean: A systematic review and meta-analysis

    Alarcón-Braga, Esteban A.; Hernandez-Bustamante, Enrique A.; Salazar-Valdivia, Farley E.; Valdez-Cornejo, Valeria A.; Mosquera-Rojas, Melany D.; Ulloque-Badaracco, Juan R.; Rondon-Saldaña, Jenny C.; Zafra-Tanaka, Jessica H. (Elsevier Inc., 2022-09-01)
    Introduction: Vaccination represents an important strategy to mitigate COVID-19 related morbidity and mortality by protecting against severe forms of the disease and reducing hospitalization and death rates. In this sense, the objective of this study is to estimate the prevalence of Vaccination Intention (VI) against COVID-19 in Latin America and Caribbean (LAC). Methods: We conducted a systematic review with a comprehensive search strategy for the following databases: PubMed, Scopus and Web of Science. A random-effect model meta-analysis was carried out using observational studies assessing the intention to vaccines against COVID-19 in LAC countries. The Clopper-Pearson method was used to estimate 95% Confidence Intervals. The quality assessment was developed using the Newcastle-Ottawa Scale adapted for cross-sectional studies. A subgroup analysis by study location and a sensitivity analysis were developed. Results: Nineteen cross-sectional studies were included. Five meta-analyzes were performed according to the target population of the included studies. The VI in the general population of LAC was 78.0% (95%CI: 74.0%–82.0%). The VI for non-pregnant women was 78.0% (95%CI: 58.0%–99.0%), for elderly population was 63.0% (95%CI: 59.0%–69.0%), for pregnant women was 69.0% (95%CI: 61.0%–76.0%) and for health-personnel was 83.0% (95% CI: 71.0%–96.0%). The sensitivity analysis for general population meta-analysis that included only low risk of bias studies showed a 77.0% VI (95%CI: 73.0%–82.0%) and for non-pregnant women, 85.0% VI (95%CI: 79.0%–90.0%). Conclusion: Despite the high prevalence of VI in general population found in our study, VI prevalence from elderly people and pregnant women are lower than other population groups and overall population.
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  • Efficacy and harms of tocilizumab for the treatment of COVID-19 patients: A systematic review and meta-analysis

    Piscoya, Alejandro; del Riego, Angela Parra; Cerna-Viacava, Renato; Rocco, Jonathon; Roman, Yuani M.; Escobedo, Angel A.; Pasupuleti, Vinay; Michael White, C.; Hernandez, Adrian V. (Public Library of Science, 2022-06-01)
    Introduction We systematically assessed benefits and harms of tocilizumab (TCZ), which is an antibody blocking IL-6 receptors, in hospitalized COVID-19 patients. Methods Five electronic databases and two preprint webpages were searched until March 4, 2021. Randomized controlled trials (RCTs) and inverse probability treatment weighting (IPTW) cohorts assessing TCZ effects in hospitalized, COVID-19 adult patients were included. Primary outcomes were all-cause mortality, clinical worsening, clinical improvement, need for mechanical ventilation, and adverse events (AE). Inverse variance random-effects meta-analyses were performed with quality of evidence (QoE) evaluated using GRADE methodology. Results Nine RCTs (n = 7,021) and nine IPTW cohorts (n = 7,796) were included. TCZ significantly reduced all-cause mortality in RCTs (RR 0.89, 95%CI 0.81–0.98, p = 0.03; moderate QoE) and non-significantly in cohorts (RR 0.67, 95%CI 0.44–1.02, p = 0.08; very low QoE) vs. control (standard of care [SOC] or placebo). TCZ significantly reduced the need for mechanical ventilation (RR 0.80, 95%CI 0.71–0.90, p = 0.001; moderate QoE) and length of stay (MD -1.92 days, 95%CI -3.46 to -0.38, p = 0.01; low QoE) vs. control in RCTs. There was no significant difference in clinical improvement or worsening between treatments. AEs, severe AEs, bleeding and thrombotic events were similar between arms in RCTs, but there was higher neutropenia risk with TCZ (very low QoE). Subgroup analyses by disease severity or risk of bias (RoB) were consistent with main analyses. Quality of evidence was moderate to very low in both RCTs and cohorts. Conclusions In comparison to SOC or placebo, TCZ reduced all-cause mortality in all studies and reduced mechanical ventilation and length of stay in RCTs in hospitalized COVID-19 patients. Other clinical outcomes were not significantly impacted. TCZ did not have effect on AEs, except a significant increased neutropenia risk in RCTs. TCZ has a potential role in the treatment of hospitalized COVID-19 patients.
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  • Oropouche virus infection in patients with acute febrile syndrome: Is a predictive model based solely on signs and symptoms useful?

    Durango-Chavez, Hilda V.; Toro-Huamanchumo, Carlos J.; Silva-Caso, Wilmer; Martins-Luna, Johanna; Aguilar-Luis, Miguel Angel; del Valle-Mendoza, Juana; Puyen, Zully M. (Public Library of Science, 2022-07-01)
    Background Oropouche fever is an infectious disease caused by the Oropouche virus (OROV). The diagnosis and prediction of the clinical picture continue to be a great challenge for clinicians who manage patients with acute febrile syndrome. Several symptoms have been associated with OROV virus infection in patients with febrile syndrome; however, to date, there is no clinical prediction rule, which is a fundamental tool to help the approach of this infectious disease. Objective To assess the performance of a prediction model based solely on signs and symptoms to diagnose Oropouche virus infection in patients with acute febrile syndrome. Materials and methods Validation study, which included 923 patients with acute febrile syndrome registered in the Epidemiological Surveillance database of three arbovirus endemic areas in Peru. Results A total of 97 patients (19%) were positive for OROV infection in the development group and 23.6% in the validation group. The area under the curve was 0.65 and the sensitivity, specificity, PPV, NPV, LR + and LR- were 78.2%, 35.1%, 27.6%, 83.6%, 1.20 and 0.62, respectively. Conclusions The development of a clinical prediction model for the diagnosis of Oropouche based solely on signs and symptoms does not work well. This may be due to the fact that the symptoms are nonspecific and related to other arbovirus infections, which confuse and make it difficult to predict the diagnosis, especially in endemic areas of co-infection of these diseases. For this reason, epidemiological surveillance of OROV in various settings using laboratory tests such as PCR is important.
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  • High prevalence and clinical characteristics of respiratory infection by human rhinovirus in children from Lima-Peru during years 2009- 2010

    Castañeda-Ribeyro, Ariana; Martins-Luna, Johanna; Verne, Eduardo; Aguila-Luis, Miguel Angel; Silva-Caso, Wilmer; Ugarte, Claudia; Carrillo-Ng, Hugo; Cornejo-Tapia, Angela; Tarazona-Castro, Yordi; del Valle-Mendoza, Juana (Public Library of Science, 2022-07-01)
    Introduction Human rhinovirus is a major cause of acute respiratory infections (ARIs) worldwide. Epidemiological data on human rhinovirus (RV) in Peru is still scarce, as well as its role in respiratory infections in children. Therefore, the aim of this study was to describe the prevalence of rhinovirus and to identify the circulating species in nasopharyngeal swabs from children with acute respiratory infections. Materials and methods We analyzed nasopharyngeal swab samples that were collected from children younger than 17 years old, who had a clinical diagnosis of ARI from the "Hospital Nacional Cayetano Heredia"between May 2009 and December 2010. The original study recruited 767 inpatients with ARI, 559 samples of which were included and analyzed in the current study. Detection of rhinovirus and determination of rhinovirus species were characterized by PCR. Results Rhinovirus was detected in 42.22% samples (236/559), RV-A was detected in 10.17% (24/ 236) of the cases, RV-B in 16.53% (39/236), and RV-C in 73.31% (173/236). The age group with the highest number of cases was the 0-5 months group with 45.97%, followed by the 1-5 years group with 25.22%. Most of the positive RV cases, i.e., 86.44% (204/236), were hospitalized. The most common signs and symptoms found in patients who tested positive for RV were cough (72.88%), fever (68.64%), rhinorrhea (68.22%), and respiratory distress (61.44%). Infection with RV-A was associated with wheezing (p = 0.02). Furthermore, RV-C was related to cough (p = 0.01), wheezing (p = 0.002), and conjunctival injection (p = 0.03). A peak in RV-C cases was found in March (32 cases in 2010); June (18 cases in 2009 and 12 cases in 2010), which corresponds to the fall season in Peru; and also November (17 cases in 2009 and 4 cases in 2010), which corresponds to spring. RV-A and RV-B cases were constant throughout the year. Conclusion In conclusion, we found a high prevalence of rhinovirus C infection among pediatric patients with acute respiratory infections in Lima, Peru. This viral infection was more common in children between 0 to 5 months old, and was associated with cough, wheezing, and conjunctival injection. Epidemiological surveillance of this virus should be strengthened/encouraged in Peru to determine its real impact on respiratory infections.
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  • Entrustable professional activities: Towards standardization of language and meaning in Spanish and Portuguese

    Melo de Andrade, Marcus Vinicius; López, María José; Torres, Luis Carlos Domínguez; Pérez, Verónica Daniela Durán; Durante, Eduardo; Barreto, Samuel Eloy Gutiérrez; Sierra, Manuel Eduardo Gutiérrez; Casallas, Julio César García; Francischetti, Ieda; Melanchthon, Isabel Eugenia Mora; Mendiola, Melchor Sánchez; ten Cate, Olle (Universidad Nacional Autonoma de Mexico, 2022-01-01)
    The EPAs approach has had a great impact on medical education since it emerged in 2005. Its dissemination has required translation into several languages, sometimes generating terminological and meaning confusion. This paper is the result of an expert consensus procedure regarding the translation of key terms for understanding the EPA approach in Spanish and Portuguese. It was carried out through a process of meaning analysis of each term in its idiomatic context and of the practice of health professionals training in Latin America. Participated on this consensus by twelve professionals, teachers and scholars involved in the implementation and training with EPAs in eight countries, who participated as coordinator, facilitators or participants in the International Course Ins and Outs of EPAs for Latin America.
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  • COVID-19 and Food Insecurity in Latin America and the Caribbean

    Hernández-Vásquez, Akram; Visconti-Lopez, Fabriccio J.; Chacón-Torrico, Horacio; Azañedo, Diego (Taylor and Francis Ltd., 2022-01-01)
    The objective was to determine the prevalence of household food insecurity (FI) in Latin America and the Caribbean (LAC) during the COVID-19 pandemic. Secondary analysis was performed using the waves 1 to 3 of the 2020 COVID-19 High Frequency Phone Surveys in 13 LAC countries. The countries with the highest FI in the first wave were Honduras (60.3%), Peru (58.1%) and Ecuador (57.9%). Likewise, the countries with the greatest differences in the prevalence of FI between the first and last waves in percentage points (PP) were Peru (−29), Guatemala (−27.7) and Bolivia (−21.8). LAC countries face a great burden of FI.
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  • Acute presentation of post-traumatic stress by COVID-19

    Reyes-Tejada, Alejandra L.; Gonzales-Huaman, Keysi S.; Leon-Nina, Estefania C.; Murga-Cabrera, Anne E.; Carrasco-Altamirano, Jhosimar A.; Mejia, Christian R. (Editorial Ciencias Medicas, 2022-04-01)
    Introduction: COVID-19 has generated diverse reactions and social changes in different populations, which may influence mental health. Objective: To describe the characteristics and risk factors of post-traumatic stress by COVID-19 in the Peruvian population. Methods: A retrospective cohort was studied in 2276 people over 18 years of age. The diagnosis of post-traumatic stress disorder was obtained with the Short Post-traumatic Stress Disorder Rating Interview (SPRINT-E) scale (α = 0.92), which was crossed with important variables; association statistics were obtained. Results: The main risk factors for post-traumatic stress were being a woman (p < 0.001); having obesity or cardiovascular disease (p < 0.001); spending more hours per day being informed about the subject (p< 0.001); having a family member who had suffered from post-traumatic stress disorder (p < 0.001); having a relative who has suffered from COVID-19 (p = 0.045), having a relative or friend who has died from this disease (p = 0.020); having relatives with psychiatric diagnoses (p = 0.018); having a harmful habit (p < 0.001), suffering from depression, anxiety or stress (p < 0.001; for each of the three disorders). On the contrary, the older the age (p<0.001) and the higher the academic degree (p<0.001), the lower the risk of post-traumatic stress. Conclusion: The factors associated with post-traumatic stress due to COVID-19 in the Peruvian population are obesity or cardiovascular disease, possession of harmful habits, family psychiatric history, having family members infected or killed by COVID-19, and suffering from depression, anxiety or stress.
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  • Poor sleep Quality and Obstructive Sleep Apnea are Associated with Maternal Mood, and Anxiety Disorders in Pregnancy

    Rubio, Elia; Levey, Elizabeth J.; Rondon, Marta B.; Friedman, Lauren; Sanchez, Sixto E.; Williams, Michelle A.; Gelaye, Bizu (Springer, 2022-07-01)
    Background: Previous studies suggest sleep quality and obstructive sleep apnea (OSA) may be associated with psychiatric symptoms, including depression, anxiety, and posttraumatic stress disorder (PTSD). However, few studies have examined the relationship between sleep quality and OSA with maternal psychiatric symptoms during pregnancy, a state of vulnerability to these disorders. Objective: The objective of our study is to examine the association between poor sleep quality and sleep apnea with antepartum depression, anxiety, and PTSD among pregnant women. Methods: A cross-sectional study was conducted among women seeking prenatal care in Lima, Peru. Sleep quality was measured using the Pittsburgh Sleep Quality Index, and the Berlin questionnaire was used to identify women at high risk for OSA. Depression, generalized anxiety, and PTSD symptoms were measured using the Patient Health Questionnaire-9, Generalized Anxiety Disorder Assessment, and PTSD Checklist – Civilian Version. Multivariate logistic regression procedures were used to estimate adjusted odds ratios (aOR) and 95% confidence intervals (95% CI). Results: Approximately 29.0X% of women had poor sleep quality, and 6.2% were at high risk for OSA. The prevalence of psychiatric symptoms was high in this cohort with 25.1%, 32.5%, and 30.9% of women reporting symptoms of antepartum depression, antepartum anxiety, and PTSD, respectively. Women with poor sleep quality had higher odds of antepartum depression (aOR = 3.28; 95%CI: 2.64–4.07), generalized anxiety (aOR = 1.94; 95%CI: 1.58–2.38), and PTSD symptoms (aOR = 2.81; 95% CI: 2.28–3.46) as compared with women who reported good sleep quality. Women with a high risk of OSA had higher odds of antepartum depression (aOR = 2.36; 95% CI: 1.57–3.56), generalized anxiety (aOR = 2.02, 95% CI: 1.36–3.00), and PTSD symptoms (aOR = 2.14; 95%CI: 1.43–3.21) as compared with those with a low risk of sleep apnea. Conclusions: Poor sleep quality and high risk of OSA are associated with antepartum depression, generalized anxiety, and PTSD symptoms among pregnant women. Further characterizations of the associations of these prevalent sleep, mood, and anxiety conditions among pregnant women could aid in evaluating and delivering optimal perinatal care to women with these comorbidities.
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  • Comparative Performance of the Resilience Inventory (IRES) and Resilience Scale-14 (RS-14) Spanish Versions Among Postpartum Adolescent Mothers

    Rojas Perez, Oscar F.; Sanchez, Sixto E.; Cruz, Victor; Sánchez, Elena; Levey, Elizabeth; Gelaye, Bizu (Springer Science and Business Media Deutschland GmbH, 2022-01-01)
    We sought to evaluate the psychometric properties of two resilience scales; the Resilience Inventory (IRES) and the 14-item Resilience Scale (RS-14) among Peruvian postpartum adolescent mothers. This cross-sectional study included 785 adolescent mothers who delivered at a maternity hospital in Lima, Peru. The Spanish versions of IRES and RS-14 were used to evaluate the properties of the measures. We examined reliability using Cronbach’s alpha. We used exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess the construct validity and factor structures of the two scales. Both scales had good internal consistency (Cronbach’s alpha > 0.7). Correlation between IRES and RS-14 scores was fair (r = 0.53). The EFA results of both scales yielded a three-factor structure. EFA including all items from IRES and RS-14 yielded a six-factor structure. CFA results corroborated the original seven-factor structure for IRES and yielded measures indicating a good level of goodness of fit (comparative fit index of 0.93) and accuracy (root mean square error of approximation of 0.07). Overall, Spanish language versions of both the IRES and the RS-14 are reliable and valid scales for assessing resilience among Peruvian postpartum adolescent mothers. Additional research is needed to integrate culturally-specific traits into resilience measures.
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  • Global research in arthroscopy of the anterior cruciate ligament: A bibliometric and visualized study

    Visconti-Lopez, Fabriccio J.; Hernández-Vásquez, Akram; Azañedo, Diego; Sanchez Carbonel, Jose Fernando (Reed Elsevier India Pvt. Ltd., 2022-07-01)
    Purpose: To carry out a bibliometric analysis of the scientific articles that address the topic of arthroscopy of the anterior cruciate ligament (ACL). Methods: A bibliographic search of the original articles published in orthopedics journals indexed in the Web of Science database until 2020 was carried out. Evaluation of compliance with the inclusion criteria was carried out in the Rayyan web application. The Bibliometrix package in the R programming language and VOSviewer were used to perform the bibliometric analysis. Results: 2249 articles published in 87 journals were included. The first publication on the subject was in 1980, and the highest number of publications was registered in 2020 (151) (annual percentage growth rate of 5.7). Fu FH was the author with the highest number of published articles, and the institutional affiliation with the highest number of original articles was the University of Pittsburgh. The most cited article was the study by Peterson et al. (2000) and the journal with the highest number of publications was Arthroscopy: the journal of arthroscopic and related surgery. United States had the highest frequency of publications and the highest number of total citations received by country. It was found on the network that the largest number of published studies had keywords such as: injuries and follow-up, whereas, in the most recent articles, the most common terms were risk-factors and outcomes. Conclusions: There is a sustained increase in scientific production on ACL arthroscopy among the world scientific community. Our results can be used for collaborative research purposes and by professionals seeking training in this topic.
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  • Effects of the COVID-19 pandemic on the prevalence of obsessive-compulsive symptoms among young adults in Peru

    Nicolas, Galdos Bejar Marcelo; Ivana, Belanovic Ramirez; Valeria, Santander Alva; Hanae, Zafra Tanaka Jessica (Mahidol University - ASEAN Institute for Health Development, 2022-05-01)
    The COVID-19 pandemic has exposed the general population to constant stressful and traumatic situations. This, added to the necessary and constant dissemination of preventive measures for COVID-19 infection, can generate an increase in the prevalence of Obsessive-Compulsive (OC) symptoms. Thus, this research aimed to evaluate the prevalence of OC symptoms and explore associated factors in young adults in Peru, the country with the highest COVID-19 death rate in the world. In this analytical cross-sectional study, an online survey distributed through social networks was used. OC symptomatology during the last week was measured by the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). Possible Generalized Anxiety Disorder (GAD) and Major Depressive Disorder (MDD) were evaluated with the General Anxiety Disorder 7-items (GAD-7) and Patient Health Questionnaire-9 (PHQ-9), respectively. 1243 young adults were evaluated. Of these, the mean age was 24.1 years, 54.3% were women, and the prevalence of OC symptoms was 50%. Participants who had experienced a traumatic event during COVID-19 pandemic had higher prevalence of OC symptoms (PR 1.54; CI 95% 1.27 – 1.85), when compared to those did not experience such events. In the same way, participants diagnosed with depression (PR 2.37; CI 95% 1.96 – 2.86) and anxiety (PR 1.11; CI 95% 1.02 – 1.21) also had a higher prevalence of OC symptoms, compared with those without depression and anxiety. In conclusion, obsessive-compulsive symptomatology has a high prevalence in young adults, and is associated with the death of a family member or close friend from the COVID-19 disease. The prevalence of possible depression and anxiety are high and are associated with higher prevalence of obsessive-compulsive symptoms. This highlights the importance of including mental health programs during the pandemic for the population who has suffered traumatic events, to be able to give them adequate follow-up and support.
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  • Ineffective penicillin treatment and absence of partner treatment may drive the congenital syphilis epidemic in Brazil

    Swayze, Emma J.; Cambou, Mary Catherine; Melo, Marineide; Segura, Eddy R.; Raney, Julia; Santos, Breno Riegel; Lira, Rita; Pinto, Raquel Borges; Varella, Ivana Rosangela dos Santos; Nielsen-Saines, Karin (Elsevier Inc., 2022-05-01)
    BACKGROUND: Reducing congenital syphilis has been the focus of Brazilian health programs for decades, yet the cases continue to increase. Although health interventions have targeted HIV screening and treatment, syphilis management continues to be challenging. Syphilis during pregnancy may enhance the HIV maternal seroconversion risk. The potential factors fueling the syphilis epidemic were evaluated in south Brazil, an area of high HIV or syphilis endemicity. OBJECTIVE: We hypothesized that ineffective treatment because of a lack of partner treatment, late presentation to care, and reinfection of previously treated mothers were potential drivers of syphilis mother-to-child transmission. STUDY DESIGN: Data on women diagnosed with syphilis during pregnancy between January 1, 2008 and December 31, 2018 were obtained from a large urban hospital in Porto Alegre, Brazil. The patients were stratified into effective vs ineffective treatment groups according to the World Health Organization guidelines. Crude and adjusted risk ratios for the prediction of congenital syphilis and adverse fetal or neonatal outcomes were computed using Poisson regression. RESULTS: Nearly 56,000 pregnant women delivered over the 11-year period; 1541 (2.8%) had confirmed syphilis during pregnancy, with 934 (61%) receiving ineffective syphilis treatment because of late presentation and diagnosis, delayed treatment initiation, and loss to follow-up with no treatment recorded. Ineffective treatment was associated with maternal education, prenatal care, timing of syphilis diagnosis, venereal diseases research laboratory titers, and maternal HIV coinfection. On multivariate regression analysis, ineffective treatment (adjusted risk ratio, 4.52; 95% confidence interval, 2.35–8.69), absence of prenatal care (adjusted risk ratio, 9.31; 95% confidence interval, 3.77–23.0), syphilis diagnosis at delivery (adjusted risk ratio, 3.08; 95% confidence interval, 2.07–4.58), and maternal nontreponemal titers ≥1:64 (1.09–1.93) were associated with an increased risk of fetal loss. Ineffective treatment (adjusted risk ratio, 1.71; 95% confidence interval, 1.59–1.84), year of diagnosis 2014 to 2016 (adjusted risk ratio, 1.07; 95% confidence interval, 1.02–1.13), absence of prenatal care (adjusted risk ratio, 1.44; 95% confidence interval, 1.17–1.76), and maternal nontreponemal titers >1:4 were associated with an increased risk of congenital syphilis. Although partner treatment reduced the congenital syphilis risk (adjusted risk ratio, 0.60; 95% confidence interval, 0.55–0.66), only 31.8% of partners received treatment. Maternal HIV coinfection was not associated with an increased risk of fetal loss, low birthweight, preterm birth, congenital syphilis, or symptomatic neonatal infection. CONCLUSION: Public health initiatives promoting effective syphilis treatment in pregnancy, increased access to high-quality prenatal care, and partner treatment should be considered to reduce congenital syphilis.
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