La prevalencia de la diabetes mellitus tipo 2 está aumentando, especialmente en países de ingresos bajos y medios, donde la situación empeora porque aproximadamente la mitad de los casos desconocen la enfermedad. El examen universal que utiliza marcadores de sangre puede ser un desafío en entornos con recursos limitados. La identificación de estos individuos puede abordarse potencialmente utilizando puntajes de riesgo y herramientas de evaluación de neuropatía. Este estudio tuvo como objetivo evaluar la precisión diagnóstica del FINDRISC, un puntaje de riesgo libre de sangre, tres herramientas de evaluación de neuropatía (EZSCAN, pupilómetro y biotesiómetro), solo y en combinación. Se realizó un estudio basado en la población que incluyó una muestra aleatoria estratificada por sexo de participantes de Tumbes, un área semiurbana en el norte de Perú. La DM2 no diagnostic...

Objective: to describe the existing patterns of mortality in Peru, at the national and regional level. Materials and methods: a secondary analysis using national death records from 2003 to 2016 was conducted. The Global Burden of Disease 20017 approach was utilized to group underlying causes of death into five groups: non-communicable diseases, infectious diseases, maternal and neonatal, nutritional, and injury deaths. The Mann-Kendall tau test was used to assess trends and changes of causes of death over time. Results: between 2003 and 2016, a total of 1′295,290 deaths at the national level were recorded, but only 698,037 records were analyzed. For 2003, 63.9% of deaths were attributed to non-communicable diseases, whereas 16.9% were due to infectious diseases, and 8.8% for injuries. For 2016, 83.6% of deaths were attributed to non-communicable diseases (p-value for trends < 0.001)...

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Objectives: The EZSCAN is a non-invasive device that, by evaluating sweat gland function, may detect subjects with type 2 diabetes mellitus (T2DM). The aim of the study was to conduct a systematic review and meta-analysis including studies assessing the performance of the EZSCAN for detecting cases of undiagnosed T2DM. Methodology/Principal findings: We searched for observational studies including diagnostic accuracy and performance results assessing EZSCAN for detecting cases of undiagnosed T2DM. OVID (Medline, Embase, Global Health), CINAHL and SCOPUS databases, plus secondary resources, were searched until March 29, 2017. The following keywords were utilized for the systematic searching: type 2 diabetes mellitus, hyperglycemia, EZSCAN, SUDOSCAN, and sudomotor function. Two investigators extracted the information for meta-analysis and assessed the quality of the data using the Revised ...

OBJECTIVE: This study aims to assess the needs of people with disabilities and their level of inclusion in social protection programmes. DESIGN: Population based-survey with a nested case-control study. SETTING: Morropon, a semiurban district located in Piura, northern Peru. PARTICIPANTS: For the population survey, a two-stage sampling method was undertaken using data from the most updated census available and information of each household member aged ≥5 years was collected. In the nested case-control study, only one participant, case or control, per household was included in the study. PRIMARY AND SECONDARY OUTCOME MEASURES: Disability was screened using the Washington Group short questionnaire. A case, defined as an individual aged ≥5 years with disabilities, was matched with one control without disabilities by sex and age (±5 years). Information was collected on socioeconom...

Proyecto de investigación 2017-2019, financiado por la Universidad Peruana de Ciencias Aplicadas (UPC).

Objetivo: Identificar factores asociados a fracaso de terapia en pacientes con tuberculosis pulmonar durante los 2 primeros meses de tratamiento específico, basados en el peso, el índice de masa corporal (IMC) y el esputo. Materiales y Métodos: Estudio retrospectivo de tipo caso-control apareado por sexo y edad (± 2 años), llevado a cabo en Pampas de San Juan de Miraflores. Todas los fracasos a tratamiento entre el año 2000 y junio del 2005 con frotis positivo fueron incluidos como casos; y los pacientes que ingresaron al programa con prueba de esputo positiva al inicio, y que cumplieron el criterio de cura del programa fueron los controles, 2 por cada caso Resultados: Veintiocho casos fueron apareados con 56 controles. Los factores asociados a fracaso fueron: al inicio del tratamiento, el antecedente de tratamiento previo (OR = 3,54, IC 95%: 1,22-10,26). Al mes de tratamien...

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Objetivo: Evaluar y analizar la evolución de la tuberculosis desde el año 2000 al 2004 en una zona urbano marginal de Lima. Materiales y métodos: Este es un estudio observacional de reporte de casos, realizado en Pampas de San Juan desde enero del 2000 hasta diciembre del 2004. Los datos se obtuvieron del Libro de Sintomáticos respiratorios y del Libro de Evolución y seguimiento de casos de tuberculosis del programa. Resultados: Se diagnosticaron 694 casos de tuberculosis en el periodo de estudio, de los cuales 528 casos eran nuevos (76,1%). La forma pulmonar fue la más diagnosticada con 530 casos, teniendo el 82,1% baciloscopía positiva. La incidencia ha disminuido desde 208.96 hasta 187.05 por 100000 habitantes. La condición de egreso hasta fines del 2003 fue de 427 curados (87,5%), 27 abandonos (5,5%), 13 fracasos (2,7%) y 21 fallecidos durante el tratamiento (4,3%). Co...

Objective: to describe the existing patterns of mortality in Peru, at the national and regional level. Materials and methods: a secondary analysis using national death records from 2003 to 2016 was conducted. The Global Burden of Disease 20017 approach was utilized to group underlying causes of death into five groups: non-communicable diseases, infectious diseases, maternal and neonatal, nutritional, and injury deaths. The Mann-Kendall tau test was used to assess trends and changes of causes of death over time. Results: between 2003 and 2016, a total of 1′295,290 deaths at the national level were recorded, but only 698,037 records were analyzed. For 2003, 63.9% of deaths were attributed to non-communicable diseases, whereas 16.9% were due to infectious diseases, and 8.8% for injuries. For 2016, 83.6% of deaths were attributed to non-communicable diseases (p-value for trends < 0.001)...

Introducción: Aproximadamente 350 millones de personas tienen depresión. La presencia de hipertensión arterial es un factor de riesgo importante para la salud mental. Sin embargo, varios estudios sobre la asociación entre la hipertensión arterial y los síntomas depresivos presentan evidencia controvertida. El objetivo fue identificar si existe una asociación entre la hipertensión arterial y los síntomas depresivos, teniendo en cuenta el tiempo transcurrido desde el diagnóstico de hipertensión. Conclusión: existe una asociación entre la hipertensión y los síntomas depresivos, pero esto varía según el tiempo transcurrido desde el diagnóstico. Por lo tanto, las personas con <1 año desde el diagnóstico tenían la mayor probabilidad de tener síntomas depresivos; después de eso, esa probabilidad disminuyó a medida que aumentó el tiempo desde el diagnóstico. Métodos: S...

Purpose: To assess whether the participation in food assistance programs (Community Kitchens and Glass of Milk) was associated with lipid profile patterns in the Peruvian population. We conducted a secondary data analysis using data from the National Survey of Nutritional, Biochemical, Socioeconomic, and Cultural Indicators related to Chronic Degenerative Diseases. The sample included individuals aged ≥20 years, selected from five geographic strata in Peru. From each stratum a random sample of clusters was chosen. Different Poisson regression models with robust variance were built to determine the association between food assistance programs and participant lipid profile (total cholesterol (TC), HDL-cholesterol (HDL-c), LDL-cholesterol and triglycerides (TG)). Data from 4028 participants was analyzed, 123 (3.1%) reported being beneficiaries of the Community Kitchens program and 827 (20...

Objective. To estimate cause of death and to identify factors associated with risk of inhospital mortality among patients with T2D. Methods. Prospective cohort study performed in a referral public hospital in Lima, Peru. The outcome was time until event, elapsed from hospital admission to discharge or death, and the exposure was the cause of hospital admission. Cox regression was used to evaluate associations of interest reporting Hazard Ratios (HR) and 95% confidence intervals. Results. 499 patients were enrolled. Main causes of death were exacerbation of chronic renal failure (38.1%), respiratory infections (35.7%), and stroke (16.7%). During hospital stay, 42 (8.4%) patients died. In multivariable models, respiratory infections (HR = 6.55, ), stroke (HR = 7.05, ), and acute renal failure (HR = 16.9, ) increased the risk of death. In addition, having 2+ (HR = 7.75, ) and 3+ (HR = 21.1,...

PeerJ, 23(3), e1046

OBJECTIVES: To estimate the incidence and risk of childhood overweight and obesity according to socioeconomic status in Peruvian and Vietnamese school-aged children. METHODS: Longitudinal data from the Young Lives study were analyzed. Exposure was wealth index in tertiles. Outcome was overweight and obesity. Cumulative incidence per 100 children-years, relative risks (RR), and 95 % confidence intervals (95 % CI) were calculated. A hierarchical approach, including child- and family-related variables, was followed to construct multivariable models. RESULTS: The cumulative incidence of overweight and obesity was 4.8 (95 % CI 4.1-5.5) and 1.7 (95 % CI 1.3-2.2) in the younger and older Peruvian cohort, respectively; and in Vietnam 1.5 (95 % CI 1.2-1.8) and 0.3 (95 % CI 0.2-0.5), respectively. The incidence of overweight and obesity was higher at the top wealth index tertile in all samples. In...

Objectives. We aimed to assess if Caesarean section is a risk factor for overnutrition in early- and late-childhood, and to assess the magnitude of the effect of child- versus family-related variables in these risk estimates. Methods. Longitudinal data from Peruvian children from the Young Lives Study was used. Outcomes assessed were overweight, obesity, overnutrition (overweight plus obesity), and central obesity (waist circumference) at the age 5 (first follow-up) and 7 (second follow-up) years. The exposure of interests was delivery by Caesarean section. Relative risks (RR) and 95% confidence intervals (95% CI) were calculated using multivariable models adjusted for child-related (e.g., birth weight) and familyrelated (e.g., maternal nutritional status) variables. Results. At baseline, mean age was 11.7 (± 3.5) months and 50.1% were boys. Children born by Caesarean section were 15.6%...

OBJETIVO Investigar associação entre participação no programa de assistência alimentar e sobrepeso/obesidade, segundo nível de pobreza. MÉTODOS Estudo transversal com dados sobre 46.217 mulheres não gestantes e não lactantes, de Lima, Peru, obtidos de pesquisas, com representatividade nacional, nos anos de 2003, 2004, 2006 e 2008-2010. A variável dependente foi o sobrepeso/obesidade e a independente foi a participação no programa de assistência alimentar. Utilizou-se regressão de Poisson; os modelos foram estratificados por nível socioeconômico familiar para todo o país, por área de residência (Lima versus o resto do país; urbano versus residência rural) e anos de estudo (2003-2006 versus 2008-2010). Os modelos foram ajustados por idade, nível acadêmico, urbanização e ano de estudo. RESULTADOS Participar do programa de assistência alimentar associou-se com risco...

Objective: To assess whether the prevalence of low physical activity levels and time spent watching TV differ depending on glycemia status. Methods: A secondary analysis using data from a population-based study was conducted. Two were the outcomes: physical activity levels, derived from the International Physical Activity Questionnaire, and sitting time watching TV. The exposure was glycemia status, defined based on results of the oral glucose tolerance tests (OGTT): euglycemia, dysglycemia, and T2DM. The T2DM group was further split into: aware and unaware of T2DM diagnosis. Prevalence ratios (PR) and 95% CI were reported using Poisson regression models. Results: Data of 1607 individuals, mean age 48.2 (SD: 10.6) years, 809 (50.3%) females, were analyzed. Dysglycemia and T2DM was present in 16.9% (95% CI: 15.1%–18.8%) and 11.0% (95% CI: 9.5%–12.6%) of participants, respectively. A t...

Introduction and objectives Sleep disorders are one of the most common comorbidities among patients on hemodialysis. The aims of this study were to determine the prevalence of poor sleep quality as well as to establish potential factors associated with poor sleep quality. Materials and methods A cross-sectional study was performed enrolling patients with chronic kidney disease on hemodialysis. The outcome was sleep quality evaluated using the Pittsburgh Scale, whereas the exposure variables were time on hemodialysis, history of type-2 diabetes and hypertension, depressive symptoms, anemia, and uremia. We used Poisson regression model to determine the association of interest, reporting prevalence ratios (PR) and 95% confidence intervals (95%CI). Results A total of 450 patients were enrolled, 259 (57.5%) were male, aged from 18 to 97 years. The prevalence of poor sleep quality was 79.3% (9...

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