• Accidente cerebrovascular y discapacidad severa al alta en población pediátrica hospitalizada durante el periodo 2004-2016 en un centro de referencia peruano

      Soto Tarazona, Alonso Ricardo; Escalante Kanashiro, Raffo; Llerena Matienzo, Laura Sthefanie (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-25)
      Introduction: it is estimated that Pediatric stroke is in the top ten causes of death in this age group.3 It is an infrequent disease; nevertheless, is considered one of the principal causes of disability in children. 2,13 Cardiac congenital malformations are to be known as a predisponent factor for ischemic stroke. In the case of hemorrhagic stroke, the principal predisponent factor is artheriovascular cerebral malformations. Objective: describe the frequency of ACV type and scale of disability at discharge after a pediatric stroke in a Peruvian national hospital. Methodology: a descriptive transversal study will be applied to hospitalized patients due to a stroke at the “Instituto Nacional de Salud del Niño”. Results: a total of 140 clinical history charts were analyzed, stroke was more frequent in infants (33,6%) and the male group (67,9%). The intracerebral hemorrhage was the principal typo of stroke (43%). The frequency of severe disability according to PSOM scale was 32,2% and 22,1% with KOSCHI scale. Conclusion: the presence of predisponent factors such as vascular diseases or coagulopathies are frequent. Thus the importance to stablish risk factors in order to determine which patient has more risk and give an early treatment.
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    • Actividad física en el trabajo y su asociación con síndrome metabólico: un estudio de base poblacional en Perú

      Bernabé Ortiz, Antonio; Arsentales Montalva, Valeria; Tenorio Guadalupe, María Del Rosario; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-15)
      Introduction: The priority role of physical activity, both in the prevention and in the management of the components of the metabolic syndrome, has been widely established in the last decade. Objectives: To evaluate the association between physical activity levels at work and the presence of metabolic syndrome among individuals aged ≥20 years in different geographical settings of Peru. Materials and methods: A secondary analysis of a population-based survey was conducted. Five population strata of Peru were included. The data were in accordance with the methodology of the National Institute of Statistics and Informatics. The diagnosis of metabolic syndrome was established according to internationally consensus criteria, based on the anthropometric, biochemical and clinical parameters that are involved in its diagnosis. The exposure of interest was physical activity at work, split into high, moderate and low levels. To evaluate the association of interest, the Poisson regression model was used and crude and adjusted models were created. Results: The data of 4029 individuals were analyzed, average age of 42.1 years (SD 15.3) and 2013 (50.0%) were women. A total of 1011 (25.1%; 95% CI: 23.8% - 26.5%) subjects presented metabolic syndrome, and this percentage varied according to the study region. Metabolic syndrome was more frequent in Lima (29.6%) and the rest of the Coast (30.8%), and less frequent in the rural Sierra (17.4%, p<0.001). The multivariate model showed evidence of association between physical activity at work and the presence of metabolic syndrome. When compared to those who had high physical activity levels at work, those who reported moderate levels of physical activity were 1.51 (95% CI: 1.25-1.81) more likely to have metabolic syndrome, whereas among those with low levels of physical activity levels at work the association was stronger (1.71, 95% CI: 1.42 - 2.07). Conclusions: Low levels of physical activity at work are strongly associated with the presence of metabolic syndrome. For this reason, measures to increase the performance of physical activity at work should be promoted to contribute to the reduction of the prevalence of MS in our population.
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    • Adaptación cultural y validación del SATAQ-4 “Sociocultural Attitudes towards appearance Questionnaire-4” para población peruana

      Mayta-Tristan, Percy; Maguiña Quispe, Jorge; Catacora Villasante, Manuel; Zevallos Delzo, Carolina Mercedes (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-02-23)
      Cultural adaptation and validation of the SATAQ-4 “Sociocultural Attitudes towards appearance Questionnaire-4” for Peruvian population Introduction: Eating disorders (anorexia and bulimia) have been increasing worldwide and nationally. Prior to the development of this disorder, adolescents’ present body dissatisfaction, whose study through the ¨Tripartite Influence Model¨ gives us three main pressures: Pressure on the part of parents, the media and peers. Factors that study through the SATAQ-4. Objective: Validate the Peruvian version of SATAQ-4 "Sociocultural Attitudes Toward Appearance-4 Questionnaire". Methods: A cross-sectional study was carried out in 2015. It was started by culturally adapting the test. Subsequently, validity was determined through the validity of the construct, and reliability through internal consistency assessment and intra-observer reliability (test-retest). Results: A culturally adapted instrument was obtained obtaining a final average of the mayor to 3 according to the Delphi method, with a good intraclass relation (0.83), a high internal consistency (alpha cronbach: 0.90), that make the adjustment with the Confirmatory factor analysis supported the original five-factor structure and with a good quality of convergence (r Pearson: 0.70) when evaluating compared to the BSQ. Conclusions: The instrument adequately obtained the construct for which it was created and can be applied in the Peruvian university environment.
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    • Agreeableness (cordialidad) y estigma hacia pacientes con enfermedad mental en estudiantes de medicina humana

      Alvarado Cutipa-Flores, German F.; Medina Conde, Bryan Benghy (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-12-14)
      Objetivo: Estimar la asociación entre el puntaje de cordialidad (agreeableness) y puntaje de estigma hacia pacientes con enfermedad mental en estudiantes de medicina de una universidad peruana. Material y métodos : Estudio transversal analítico, realizado en la Facultad de Ciencias de la Salud de una universidad privada durante el 2017. Se realizó el censo desde Abril hasta Julio. La variable resultado fue el estigma. Se utilizaron las escalas Medical Condition Regard Scale (MCRS) para evaluar estigma hacia pacientes con enfermedad mental y Big Five Personality Trait Short Questionnaire (BFPTSQ) para cordialidad (agreeableness). Se calcularon Z scores para ambas encuestas. Respecto a BFPTSQ, a más puntaje hay mejor cordialidad. Respecto a MCRS, a más puntaje hay mayor estigma. Para el análisis de múltiples variables, se utilizó regresión múltiple. Los resultados obtenidos se expresaron según el coeficiente beta, crudo y ajustado, con un intervalo de confianza (IC) de 95%. Resultados: Se incluyeron a 324 participantes de la carrera de medicina humana. Se encontró una edad promedio de 20,2 años y la mayoría fueron de sexo femenino (57,4 %). Por cada incremento de una Desviación Estándar (DE) en (BFPTSQ), el puntaje en MCRS disminuye en 0,3 DE (β en -0,34 con un IC al 95% de -0,45 a -0,23). Por cada año de incremento de edad el puntaje en MCRS aumenta en 0,06 DE (β en 0,06 con un IC al 95% de 0,01 a 0,12). El haber realizado voluntariado tiene 0,4 DE menos en MCRS (β en -0,40 con un IC al 95% de -0,67 a -0,13). Conclusiones: Se encontró asociación entre cordialidad y estigma. Quienes presentaron mayor puntaje de cordialidad mostraron menor estigma hacia pacientes con enfermedad mental en estudiantes de medicina. Objective: Determine the association between the score of agreeableness and the score of stigma in medical students towards patients with mental illness of a Peruvian university. Methods: An analytical cross-sectional study was made in the medicine school of a private university in 2017. We made a census from April to July. The outcome was stigma. The Medical Condition Regard Scale (MCRS) was used for evaluating stigma towards patients with mental illness and the Big Five Personality Trait Short Questionnaire (BFPTSQ) for agreeableness. Z scores were used for both scales. For the BFPTSQ scale, the higher score, the better agreeableness. For the MCRS scale, the higher score, the greater stigma. We used multivariate regression analysis for the variable analysis. The results were expressed according to the beta coefficient, crude and adjusted, with a confidence interval (CI) of 95%. Results: The study included 324 students in the research. For each increase of one Standard Deviation (SD) on the agreeableness scale (BFPTSQ), the score on the MCRS scale decreases by 0.3 SD (β in -0,34 with a CI 95% from -0,45 to -0,23). For each year of increase in age, the score on the MCRS scale increases by 0.1 SD (β in 0,06 with a CI 95% from 0,01 to 0,12). Students who had volunteered had 0.4 SD less on the MCRS scale (β in -0,40 with a CI 95% from -0,67 to -0,13). Conclusions: There is an association in medical students between agreeableness and stigma towards patients with mental illness. Those who have a higher level of agreeableness show less stigma.
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    • Agresión y victimización entre pares y su asociación con depresión en escolares

      Soto Tarazona, Alonso Ricardo; Veramendi Granados, Abid Mary; Lau Gutiérrez, Valeria Johanna; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-07)
      The teenage population is one of the age groups most likely to suffer from depression and are different factors that play an important role in the development of this, within them the "bullying". Objective: To establish the association between depression and aggressors and victims of bullying in high school students of public schools of Chorrillos. Methods: A secondary analysis of a study "Association between victimization by bullying and Internet addiction in Lima schoolchildren" was carried out. The variables depression, and victimization and aggression between pairs were measured, as well as sociodemographic variables. Results: Of a total of 860 students, 63.1% were male, with an average age of 14.5 +/- 1.6 years and it was found that 95.2% lived with at least one of the parents at home. 51.9% presented some degree of depression, 64.2% were categorized as medium and superior tertile of aggressors of the total them, and 62.7% as médium and superior tertile of victims of them. In the adjusted model, moderate-severe depression had a strong association with superior tertile of aggression (PR: 5.37, 95% CI: 2.98-9.66) and with victimization (PR: 4.33, 95% CI: 2.43). - 7.71). Conclusion: Depression was associated with both profiles, of the aggressor and victim of bullying.
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    • Asociación entre televisión y noticieros y el comportamiento agresivo de los adultos en el Perú urbano

      Vega Arias, Ximena; Angeles Abanto, Pedro (Universidad Peruana de Ciencias Aplicadas (UPC), 28/02/2017)
        ABSTRACT News and TV-viewing effects on adults aggresive and violent behavior in urban Peru. Objectives: To evaluate the association between the exposure to TV and news with physical partner violence, interpersonal violence and physical child abuse in some urban cities in Peru. Methods and materials: A secondary analysis was made from a study about violence in 6399 persons over 15 years old who lived in Lima, Callao, Maynas, Arequipa, Cusco, Trujillo y Huamanga. We used bivariate and multivariate logistic regression to estimate statistical association. Results: To prefer to watch news was a less probability factor of developing interpersonal violence (OR=0,62; IC 95%: 0,5-0,77; p<0,001). When performing the adjusted model including potential confounding variables, the association persisted (OR=0,71, CI 95%: 0,57 – 0,89, p=0,004). There was no association found between the other two types of violence and the preference for news and/or TV time exposure. Conclusions: People who prefer to watch news have less risk to perform interpersonal violence. Keywords: violence, domestic violence, intimate partner violence, physical child abuse, TV viewing, news viewing.
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    • Asociación de factores comunitarios y la actividad física en adolescentes de 14-15 años en Perú e India

      Tejada Caminiti, Romina Arely; Pereyra Elías, Reneé; García Aguilar, Dylan Alessandro; Silva Salazar, Luis Renato (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-07-10)
      Background: Physical inactivity is present in 80.3% of 13-15 year old teenagers. Few studies have evaluated the effects of community variables on physical activity. Our research evaluates such association in teenagers from developing countries. Methods: We performed a cross-sectional, analytical, multi-level study; a secondary analysis of the Young Lives cohort, in Peru and India. Physical activity was measured as the self-reported number of days per week that it was performed for at least 60 minutes. A community authority self-reported the presence of air pollution (due to industrial activity), robbery, gangs, drug addicts, and recreational areas. We calculated crude and adjusted exponential regression coefficient (IRR and aIRR), with 95% confidence interval (95%CI) through Poisson family mixed regression models. Results: 1494 participants were included (575 Peruvian, 919 Indian). 50,5% were male; with a median age of 14.9 (Interquartile range [RIC]: 0,6) years. The number of physical activity days in Peruvian participants that lived in communities that reported air pollution (due to industrial activity), was 35% less than the number of those who lived in communities that did not report such a problem (aIRR: 0.65; 95%CI: 0.45-0.93). The number of physical activity days of participants in Indian communities with gangs and recreational areas was 51% (aIRR: 1.51; 95%CI: 1.05-2.18) and 23% (aIRR: 1.25; 95%CI: 1.05-1.48) higher than the ones who did not report these characteristics, respectively. Conclusions: Presence of air pollution due to industrial activity was negatively associated to physical activity in Peruvian population. Presence of gangs and sport courts was positively associated to physical activity in Indian population.
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    • Asociación entre actividad física y auto-percepción de pérdida de la memoria

      Bernabé Ortiz, Antonio; Arana Chiang, Alejandra; Universidad Peruana de Ciencias Aplicadas (UPC) (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-29)
      Introduction: Memory is the information stored in neurons so that it can be recovered in the future to be used in adaptive conditions. Self-perception of memory loss itself can be an useful indicator for the screening of cognitive impairment. However, there are few studies about self-perception of memory loss and its associated factors. Objectives: To assess whether there is association between low levels of physical activity and self-perception of memory loss. Methods: Secondary data analysis from the study “Launching a salt substitute to reduce blood pressure at the population level: a cluster randomized stepped wedge trial in Peru” in which participants from 6 villages from Tumbes, Peru were collected between April to July 2014, In this study, the exposition was physical activity which has been evaluated with IPAQ and the outcome was memory loss self-perception evaluated by the British Regional Heart Study Questionnaire. Results: 2376 participants were included. Average age was 43.3 years (SD: 17.2) and 1196 (50.4%) were female. On the other hand, 293 (12.3%; IC 95% 11.0%-13.7%) participants self-perception of memory loss and 219 (74.7%) presented low physical activity. In multivariate model association between low physical activity and self-perception of memory loss was found (RP = 1.20; IC 95% 1.01 – 1.44). Conclusions: Our study evidenced association between low physical activity and self-perception of memory loss in adult population of a semiurban area of Tumbes.
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    • Asociación entre altura y cardiopatías congénitas en pacientes pediátricos en el Instituto Nacional de Salud del Niño (INSN), Lima-Perú, en los años 2017-2018

      Hernández Díaz, Adrián Vladimir; Estela Chunga, Edilberto; Ayasta Monge, Ana Lucía; Hinostroza Villacorta, Carlos Eduardo (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-12-10)
      Objetivo: Determinar si existe asociación entre altura a más de 2260 msnm (metros sobre el nivel del mar) y presencia de cardiopatías congénitas en pacientes pediátricos menores de 18 años en el INSN, Lima-Perú, en los años 2017-2018. Material y métodos: Estudio transversal en niños de la consulta externa, interconsulta, ecoconsulta y hospitalización del servicio de cardiología pediátrica, mediante la realización de encuestas a madres de los pacientes y revisión de historias clínicas. Se registró el distrito, ciudad y departamento donde las madres residieron durante el embarazo, para luego buscar la altura correspondiente. La presencia de cardiopatías congénitas fue recogida del informe ecocardiográfico en las historias clínicas. Las asociaciones fueron evaluadas en modelos de regresión de Poisson con varianza robusta, y los efectos fueron descritos como razón de prevalencia (RP). Resultados: Analizamos 570 casos (mediana: 2 años (RIC 0 a 6), 51.8% varones). La mediana de altura fue 161 msnm (157 a 182); la prevalencia de cardiopatía congénita fue de 68.07% (IC 95% 64.1 a 71.7). Se encontró 80.5% de cardiopatías congénitas acianóticas y 19.5% de cianóticas. Las más comunes fueron comunicación interventricular (29.0%), ductus arterioso persistente (17.5%), comunicación interauricular (17.0%) y Tetralogía de Fallot (3.5%). En el análisis multivariado encontramos que una gestación en zonas de más de 2260 msnm estuvo asociada a una probabilidad 20% mayor de desarrollar cardiopatías congénitas en comparación a zonas menores de 2260 msnm (RP: 1.2, IC 95% 1.1-1.3, p=0.002). La distribución de alturas de este estudio demostró que la mayoría de pacientes con cardiopatías congénitas fueron gestados a una altura menor a 1500 msnm. Adicionalmente, aquellos pacientes con síndrome de Down tuvieron un aumento significativo de probabilidad (30%) de presentar cardiopatía congénita (RP: 1.3, IC 95% 1.2-1.4, p<0.001). No existe asociación entre el número de cardiopatías congénitas y la altura de residencia. Conclusiones: En un centro de referencia pediátrico peruano encontramos que una altura mayor a 2260 msnm estuvo significativamente asociada a un 20% mayor de presentación de cardiopatías congénitas.
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    • Asociación entre apoyo social percibido y aborto inducido: estudio en centros maternos infantiles de Lima, Perú

      Piscoya, Alejandro; Bernabé Ortiz, Antonio; Rodríguez Medina, Angélica Desiree; Sánchez Siancas, Luis Enrique (Universidad Peruana de Ciencias Aplicadas (UPC), 2015-02-04)
      Objective: To determine the association between perceived social support and induced abortion among women from maternal health centers in Lima, Peru. Besides, prevalence and incidence of induced abortion were estimated in this population. Material and Methods: Cross-sectional study enrolling women aged 18 to 25 years. Induced abortion was defined using one of the Rossier methods: difference between the total number of pregnancies ended in abortion and the number of spontaneous abortions, whereas perceived social support was assessed using the DUKE-UNC scale. The association between variables of interest was estimated using generalized linear models adjusting by potential confounders. Results: A total of 298 women were enrolled, mean age 21.6 (SD: 2.2) years. Low levels of social support was found in 43.6% (95%CI 38.0%–49.3%) and 17.4% (95%CI: 13.1%– 21.8%) reported at least one induced abortion. The incidence of induced abortion was 2.37 (95%CI: 1.81–3.11) per 100 persons-year of follow-up. There was evidence of the association between social support and induced abortion (RR=1.93; 95%CI: 1.13–3.30) after controlling for potential confounders. Conclusions: There was evidence of an association between perceived social support and induced abortion among women aged 18 to 25 years. The incidence of induced abortion was similar or higher than countries where abortion is legal. A great proportion of women had low levels of social support. Strategies to increase social support and reduce induced abortion rates are needed.
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    • Asociación entre consumo de frutas y verduras con prevalencia de depresión

      Bernabe Ortiz, Antonio; Maguiña, Jorge L.; Wolniczak Rodriguez, Isabella (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-02-21)
      There is evidence suggesting a healthy diet may reduce the risk of depression. The aim of this study was to assess the association between fruits and vegetables consumption and the presence of depressive symptoms in Peru. Materials and methods: Secondary analysis of the Encuesta Nacional Demográfica y Salud Familiar (ENDES) 2014. The study included people aged 18 years and over, habitual residents of selected households. The outcome was presence of depressive symptoms evaluated using the PHQ-9 (cutoff > 14). The exposure of interest was self-reported fruit and vegetables consumption assessed using an adaptation of the questionnaire STEPs from World Health Organization (WHO) and divided into tertiles. Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated using Poisson regression models and adjusting for the study’s multistage design. Results: A total of 25901 participants were included in the analysis; of these, 13972 (53.9%) women, mean age of 44.2 (SD 17.7) years. The prevalence of fruits and vegetables consumption according to WHO recommendation was 3.5% (95%CI: 3.3%-3.7%), while depressive symptoms prevalence was 3.2% (95%CI: 3.0%-3.4%). In the multivariable analysis, and compared with the highest tertile of fruits and vegetables consumption, those in the middle tertile (PR=1.38, 95%CI 1.01-1.87) and lower tertile (PR=1.81, 95% CI 1.36-2.45) were more likely to have depressive symptoms. Conclusions: The study shows an inverse association between vegetables and fruits consumption and the presence of depressive symptoms. These results may be useful to generate strategies for promoting better diet in similar contexts.
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    • Asociación entre el consumo de alcohol y muerte en pacientes diagnosticados de tuberculosis pulmonar pansensible: Una Revisión Sistemática y Meta-análisis

      Ugarte Gil, Cesar; Sánchez Siancas , Johanna Edith (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-16)
      INTRODUCTION: Tuberculosis (TB) is one of the most important infectious diseases worldwide and is considered a public health problem since it is the first cause of death associated with a single infectious agent and it’s responsible for 1.3 million deaths despite being a curable and preventable pathology. Several health strategies have been created for the management and control of this disease, however, there are barriers that prevent its proper control which leads to negative results, being the most severe death. Among these barriers, there is alcohol consumption. OBJECTIVES: To evaluate the association between alcohol consumption and death in patients diagnosed with pulmonary tuberculosis under treatment with Isoniazide, Rifampin, Pyrazinamide and Ethambutol. METHODS: A systematic search was performed in four databases: EMBASE, LILACS, PUBMED / MEDLINE and SCOPUS. We included all the bibliography found until November 2017, taking into account cohort and cases and controls studies whose subjects were adults diagnosed with pulmonary TB under first- line antiTB treatment. The measurement of alcohol consumption for the comparison of results was classified as "alcohol consumption / no alcohol consumption" and "alcoholic / nonalcoholic". RESULTS: A total of 9 studies were included, all of them cohort. Two evaluated the risk of death during treatment in those who consumed alcohol, while seven studies did so in alcoholic patients (Pooled RR of 1.57 IC 95%: 1.21 -2.04). There was no significant variation in the variance or the pooled RR when performing an analysis based on the sensitivity of the studies. CONCLUSIONS: Alcoholism increases the risk of death during TB treatment. These results will help health personnel to implement more comprehensive actions and develop follow-up and supervision strategies in these patients who are a population at risk.
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    • Asociación entre el consumo de alcohol y resultados negativos en pacientes diagnosticados de tuberculosis pulmonar pansensible: Una revisión sistemática y meta-análisis

      Ugarte Gil, Cesar; Ochoa Fernández, Andrea Carolina; Ueda Muro, Daniela Alexandra (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-01-16)
      Resumen INTRODUCCIÓN: La tuberculosis (TB) es una enfermedad infecciosa curable y prevenible, sin embargo, cuenta con altas cifras de morbi-mortalidad, siendo así una de las patologías infecciosas más importantes en el mundo. Esto se debe a diversos factores que interfieren con un adecuado manejo de la enfermedad, resultando en una pérdida del seguimiento y/o falla al tratamiento. Entre estos factores se encuentra el consumo de alcohol. OBJETIVOS: Evaluar la relación entre el consumo de alcohol y la pérdida de seguimiento o falla durante el tratamiento de TB pulmonar. MÉTODOS: Se llevó a cabo a una búsqueda sistemática a través de EMBASE, LILACS, PUBMED/MEDLINE y SCOPUS. Se incluyó la bibliografía encontrada hasta noviembre del 2017, tomando en cuenta estudios de tipo cohorte y casos y controles cuyo sujeto de estudio fueron adultos en tratamiento de TB pulmonar. RESULTADOS: Se incluyó un total de 19 estudios, de los cuales 3 estudios de tipo cohorte buscaron asociación entre el consumo de alcohol y la pérdida de seguimiento al tratamiento de TB (RR combinado: 2.26; 95% IC: 1.26-4.03). Otros 13 artículos la asociación entre el alcoholismo y la pérdida de seguimiento, con 7 casos y controles (OR combinado: 2.86; 95% IC 2.01- 4.07) y 6 cohortes (RR combinado: 2.38; 95% IC: 1.65-3.43). No se pudo determinar asociación entre el alcoholismo y la falla al tratamiento. No hubo variación significativa en el valor RR/OR combinado al realizar un análisis basado en la sensibilidad de los estudios. CONCLUSIONES: El consumo de alcohol incrementa el riesgo de pérdida de seguimiento durante el tratamiento de TB. Este estudio incitara a detectar tempranamente a los pacientes que consumen alcohol, los cuales son una población de riesgo para desarrollar una mala respuesta al tratamiento, e implementar acciones más exhaustivas para un mejor seguimiento.
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    • Asociación entre el control glicémico en pacientes con Diabetes Mellitus tipo 2 y grado de depresión según Escala de Beck II en el Hospital Edgardo Rebagliati Martins en Octubre del 2014

      Carreazo, Nilton Yhuri; Ticona Bedia, Carlos; López Burga, Marianelly; Mariluz Cuadros, Melissa; Pereda Ginocchio, María Gracia (Universidad Peruana de Ciencias Aplicadas (UPC), 2016-02-02)
      Introduction: Depression is an important problem of public health because it is the primary cause of disabling psychiatric illness in Peru. Also, the presence of depressive symptoms could modify the adherence to the treatment and a high probability of a bad glycemic control in patients with Diabetes Mellitus type 2 (DM2). Methods: A cross-sectional analytical study was done, with 98 patients who were diagnosed with DM2, who went to the Endocrinology Department during the period of October-November 2014 in a social security hospital. We used three scales, the first one was The Beck Depression Inventory II which evaluated the presence of depressive symptoms; the scale of Problem Areas in Diabetes (PAID) evaluates the emotional stress they faced during the illness, and the Morisky-Green Scale is the third scale used which valued the adherence to the pharmacological treatment. Results: in population, the predominance was on female sex (53,8%), with a mean age of 56 years tended to be younger than 60 years (p> 0.05), married and a superior grade. BMI was associated with the presence of depressive symptoms (p 0.003), and most often found in those with obesity, type II and III. The population had 57.7% of poor glycemic control, of which 73.3% had depressive symptoms (p <0.05), and 84.1% had no adherence to treatment (p <0.05). It was found a significant association between bad glycemic control and presence of depressive symptoms independently of the potentially confounding variables with a prevalence ratio to 1.9 (1, 1 -3, 6). Conclusions: It is concluded the association between the bad glycemic control and the presence of depressive symptoms in diabetic patients. Therefore, it is suggested to use an integral approach on such patients who will be subject to a psychological evaluation.
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    • Asociación entre el hiperinsulinismo y embarazo en mujeres con síndrome de ovario poliquístico: revisión Sistemática y Meta-Análisis

      Hernandez, Adrian V.; Lázaro Alcántara, Herbert; Ríos Meléndez, Kathleen Stefanie Esther; Natividad Núñez, Augusto Alonso; Vilca Hau, Guillermo Gerónimo (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-03-10)
      OBJECTIVE: To determine the association between hyperinsulinism (HI) and pregnancy in women with polycystic ovarian syndrome (PCOS). PATTERN: Systematic Review and Meta-Analysis of observational studies that evaluated the association between hyperinsulinism and obstetric outcomes. We searched the literature through the databases of PubMed-MEDLINE, Web of Science, Embase, Scopus and Cochrane databases until June 2015. PATIENT(s): Women on reproductive age with polycystic ovarian syndrome. MAIN EFFECTS OF RESULTS: The primary outcome was pregnancy; The secondary outcomes were miscarriage, gestational diabetes and preeclampsia. For the analysis of the study we used the random effects model. RESULTS: We found 7 prospective cohorts and 4 case-control studies (n = 711). The percentage of pregnancy in women with hyperinsulinemia was significantly lower than in women without hyperinsulinemia (45/213 [21.1%] vs 114/273 [41.8%], or 0.36, 95% ci 0.21-0.62, p <0.001). There was no difference in the percentage of miscarriages between women with hyperinsulinemia and women without hyperinsulinemia (9/100 [9.0%] vs 15/147 [10.2%], or 0.90, 95% ci 0.36-2.22, p0.001). The information was scarce regarding the effects of gestational diabetes and pre-eclampsia. Conclusions: There is a significant and inverse association between hyperinsulinism and pregnancy in women with PCOS. Likewise, we do not found differences between PCOS patients with HI and PCOS patients without HI regarding the risk of miscarriage.On the other hand, there was not enough information to analyze the results of gestational diabetes and preeclampsia.
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    • Asociación entre el índice cintura talla y ansiedad en mujeres en edad mediana de 11 países de Latinoamérica: análisis secundario de un estudio multicéntrico de corte transversal

      Mezones Holguín, Edward; Blümel, Juan Enrique; Chedraui, Peter; Arroyo Alberto, Karen Jazmin; Ramos Torres, Gabriela Isabel (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-03-03)
      Objective: To evaluate the association between waist-to-height-ratio (WHtR) and anxiety in middle age women adjusted by demographic, clinical and habits variables. Methods: We carried out a secondary analysis of data from a multicenter study of women between 40 and 59 years old from 11 Latin America countries. Anxiety was assessed using the Goldberg Anxiety and Depression Scale. WHtR was calculated according World Health Organization standards and was categorized in tertiles: superior, intermediate and inferior with cut points of 0.45 y 0.6; respectively. We calculate prevalence ratios with confidence interval 95% (PR: 95%CI) by generalized linear models of Poisson family with robust standard errors both crude and adjusted models based on statistical and epidemiological criteria. Results: A total of 5580 women were analyzed. The mean age was 49.7±5.5, and 57.9% were postmenopausal. The 61.3% of women had anxiety and WHtR mean was 0.54 ± 0.1. Compared with the women in inferior tertile, the people in the intermediate (PR: 1.07; 95%CI: 1.01-1.13) and superior (PR: 1.23 95%CI: 1.07-1.29) ICT tertile were significantly more likely to have anxiety at the crude model. However, in the adjusted models only women in superior tertil had more probability of anxiety than those in inferior tertile (PR: 1.13 95%CI: 1.08-1.18). Conclusion: In this series, WHtR was associated with anxiety in middle-aged women. It is advisable to incorporate this anthropometric measure in routine clinical practice of climacteric women evaluation.
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    • Asociación entre el índice tobillo brazo y el riesgo cardiovascular en pacientes con Diabetes Mellitus tipo 2 en el Hospital Nacional Edgardo Rebagliati Martins

      Segura, Eddy R.; Rivasplata Vásquez, Esther; Zapata Cárdenas, Juana Karina; Pinelo Coll Cárdenas, Anna Caroll (Universidad Peruana de Ciencias Aplicadas (UPC), 2014-06-30)
      INTRODUCCION: La DM2 es un problema de salud pública que afecta del 2 al 5% de la población mundial. Asimismo, los pacientes con esta enfermedad tienen de 2 a 4 veces más probabilidad de presentar un ECV. Debido a ello se han establecido diversas escalas de RCV a nivel mundial, como son las escalas de Framingham y UKPDS. Existen otras formas de establecer el RCV, como es el ITB, herramienta de gran utilidad para identificar la presencia de EVP, la cual incrementa el RCV en pacientes diabéticos y en la población en general. OBJETIVO: Establecer si existe asociación entre el Índice Tobillo Brazo (ITB) con el nivel del riesgo cardiovascular (RCV) en pacientes con Diabetes Mellitus tipo 2 (DM2). MATERIALES Y METODOS: Estudio transversal de 151 pacientes con DM2, consecutivamente atendidos, adscritos al sistema del Seguro Social (ESSALUD). Se define como ITB normal a los valores comprendidos entre 0,9-1,4 e ITB anormal <0,9. Éste se calculó mediante la división de la mayor de las presiones de las arterias tibial posterior y pedia de ambos miembros inferiores, halladas con un transductor Doppler; entre la mayor de las presiones en ambos brazos, halladas con un esfingomanómetro. Por otro lado, el RCV estimado mediante las escalas de Framingham y United Kingdom Prospective Diabetes Study (UKPDS), se dividen en tres categorías: leve (<10%), moderado (10-20%) y severo (>20%). Se analizó la asociación de las variables mediante OR, análisis bivariado con p < 0,05, y además se realizaron pruebas de regresión logística. RESULTADOS: La mayoría de sujetos del estudio fueron de sexo femenino con 63,6%, la media de edad fue 61,4 años (DE 10,4). No Se encontró asociación entre el ITB y el RCV estimado según la escala de Framingham ni UKPDS (p > 0,05). Al igual que el analisis entre los factores independientes de las escalas de riesgo cardiovascular y el ITB anormal. CONCLUSIONES: En el presente estudio no se encontró asociación entre el ITB y la escala de RCV UKPDS, a pesar de ser un score específico para población diabética. Asimismo, no se encontró relación entre el ITB y la escala de Framingham.
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    • Asociación entre el resultado de BK y los resultados del tratamiento antituberculoso en niños con tuberculosis pulmonar: una revisión sistemática y meta-análisis

      Ugarte Gil, César; Encinas Saravia, Alejandro Alberto; Vásquez Valerio, Vanessa (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-11-03)
      Introducción: El diagnóstico de tuberculosis (TBC) en niños es un reto para el personal de salud, el 85% tienen BK negativo. La inversión en el diagnóstico temprano de estos niños requiere evidencia para su implementación. Nuestro objetivo mediante la revisión sistemática y meta análisis es determinar la asociación entre el resultado del BK y los resultados del tratamiento antituberculoso en niños con tuberculosis pulmonar. Métodos: La búsqueda se realizó en las bases de datos de Medline, Global Health Library y Embase. Los estudios elegidos fueron usados para comparar los resultados al tratamiento antituberculoso en niños menores de 15 años BK positivos con los BK negativos. Se realizó un meta análisis con modelo de efectos aleatorios para estimar el peso y los intervalos de confianza (IC). Resultados: Los niños que antes del tratamiento presentaban BK negativo y fallecieron presentaron un RR de 1.35 (IC 95%: 1.02-1.78). Los niños que fracasaron al tratamiento con BK negativo antes del tratamiento presentaron un RR de 0.14 (IC 95%: 0.04-0.48). No se encontró asociación entre mal resultado al tratamiento y presentar antes del tratamiento BK negativo; sin embargo, sí se encontró asociación entre los niños que antes del tratamiento presentaron BK negativo y la suma de niños fallecidos y niños que abandonaron el tratamiento con un RR de 1.29 (IC 95%: 1.01-1.65). Conclusiones: Existe asociación entre fallecer y tener BK negativo, por ello es necesario realizar un diagnóstico temprano a los niños que presenten baciloscopía negativa; de esta manera, no se retrasa el inicio del tratamiento antituberculoso. Introduction: The diagnosis of tuberculosis (TB) in children is a challenge for health personnel, 85% have smear negative. Investing in the early diagnosis of these children requires evidence for their implementation. Our objective through the systematic review and meta-analysis is to determine the association between the smear result and the results of tuberculosis treatment in children with pulmonary tuberculosis. Methods: The search was performed in the databases of Medline, Global Health Library and Embase. The studies chosen were used to compare the results of antituberculosis treatment in children younger than 15 years with smear positive and with smear negative. A meta-analysis with random effects model was performed to estimate weight and confidence intervals (CI). Results: Children who presented smear negative and died before treatment had a RR of 1.35 (95% CI: 1.02-1.78). Children who failed treatment with smear negative before treatment had a RR of 0.14 (95% CI: 0.04-0.48). Was not found asociation between poor treatment outcome and presenting smear negative before treatment; However, there was association between children who presented smear negative before the treatment and the sum of children who died and children who left treatment with a RR of 1.29 (95% CI: 1.01-1.65). Conclusions: There is association between die and having smear negative, so it is necessary to make an early diagnosis in children who present smear negative; In this way, the initiation of antituberculosis treatment is not delayed.
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    • Asociación entre el riesgo de adicción de sustancias psicoactivas y la adherencia a la terapia antiretroviral de gran actividad en personas que viven con VIH en un hospital de Lima, Perú en el periodo de 2015 – 2016

      Lucchetti Rodríguez, Aldo Javier; Fiestas Saldarriaga, Fabián Alejandro; Huertas Tirado, Sheila María; Zegarra Buitrón, Elizabeth (Universidad Peruana de Ciencias Aplicadas (UPC), 2018-02-01)
      Introducción La adherencia al tratamiento es el factor más importante para lograr éxito en la terapia anti – retroviral. Sin embargo, aquella podría verse afectada por el consumo de sustancias psicoactivas. Objetivo Evaluar la asociación entre el riesgo de adicción a sustancias psicoactivas, medido por el “Alcohol, Smoking and Substance Involvement Screening Test” (ASSIST) y la adherencia a la terapia anti - retroviral de gran actividad (TARGA) medido por el “Simplified Medication Adherence Questionnaire” (SMAQ) en personas que viven con el virus de inmunodeficiencia humana (VIH). Métodos Se desarrolló un estudio transversal en el Hospital Nacional Edgardo Rebagliati Martins (HNERM). Se aplicó una ficha de datos, y las encuestas ASSIST y SMAQ. Resultados Se obtuvo un total de169 personas que viven con VIH. El sexo masculino predomino (79,3%), la mediana de edad y tiempo en TARGA fueron 43 años (IQR 35 - 50) y 63 meses (IQR 20 – 156), respectivamente. El consumo de alcohol de bajo riesgo fue más frecuente (84,6%), y se encontró un riesgo moderado a alto de tabaco (35,5%). La adherencia global al TARGA para nuestro estudio fue baja (23,1%). Los pacientes de mayor edad presentaron mayor adherencia (42,9%), con asociación significativa en el modelo regresión logística (edad ≥ 53 años) (p=0,004; OR 8,55; IC 95% 2,00 – 36,57). Conclusiones No se encontró asociación entre el riesgo de adicción a sustancias psicoactivas y adherencia al TARGA. Se encontró una baja adherencia al TARGA según el SMAQ. Además, la edad es un factor asociado positivamente a la adherencia al TARGA.
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    • Asociación entre el tiempo de diagnóstico de enfermedad y deterioro cognitivo en pacientes con diabetes Mellitus Tipo 2 del Seguro Social en Lima Metropolitana

      Bernabe Ortiz, Antonio; Sanchez Povis, Javier; Luque Cuba, Edith Jacqueline; Cajachagua Pucuhuaranga, Ketty Liz; Lanegra Medina, Patricia Del Pilar; Zuloaga Salas, Carmen Rosa (Universidad Peruana de Ciencias Aplicadas (UPC), 2017-03-07)
      ASSOCIATION BETWEEN THE TIME OF DIAGNOSIS OF ILLNESS AND COGNITIVE IMPAIRMENT IN PATIENTS WITH MELLITUS DIABETES TYPE 2 SOCIAL SECURITY IN LIMA METROPOLITANA ABSTRACT Introduction Type 2 diabetes mellitus is associated with an increased risk of developing cognitive impairment. The aim of this study was to evaluate the association between years of disease diagnosis and cognitive impairment in patients with type 2 diabetes mellitus. Material and methods An analytical cross-sectional study was carried out enrolling patients assisted by the External Consultative Service of Endocrinology in three hospitals of the Social Health Insurance (ESSALUD). Sampling was non-probabilistic with consecutive enrollment. People of both sexes, aged 45 years and older, were included and voluntarily consented to participate in the study. All participants were given the Leganés Cognitive Test (cut-off point ≤22) for cognitive impairment. The exposure of interest was years of diagnosis of diabetes, defined as the self-report of the number of years elapsed from diagnosis to interview and then categorized into groups (≤5, 5-9, 10-14,15-19 and ≥ 20 years). The prevalence ratio (PR) and the 95% confidence intervals (95% CI) were estimated to evaluate the association of the variables of interest. Results A total of 614 participants were evaluated, 54.2% women, and an average age of 66.6 (SD: 4.2). The average disease duration was 14.6 years (SD: 10.4) and 195 (31.8%) had 20 or more years of illness. The prevalence of cognitive impairment was 36.8% (95% CI 33.0% - 40.6%). In the adjusted analysis, those patients with ≥ 20 years of diabetes diagnosis were more likely to have cognitive impairment (RR: 1.59; 95% CI: 1.10-2.29) compared to those with <5 years of disease Conclusion There is a positive association between the time of diagnosis of disease in patients with diabetes and the presence of cognitive impairment.
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