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artículo
Publicado 2019
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Type 2 diabetes mellitus (T2DM) is associated with a high mortality risk, although the magnitude of this association remains unknown in Latin America (LA). We aimed to assess the strength of the association between T2DM and all-cause and cause-specific mortality in population-based cohort studies in LA. Systematic review and meta-analysis: inclusion criteria were (1) men and women 18 years old and above with T2DM; (2) study outcomes all-cause and/or cause-specific mortality; and (3) using people without T2DM as comparison group. Five databases (Scopus, Medline, Embase, Global Health, and LILACS) were searched. Risk of bias was evaluated with the ROBINS-I criteria. Initially, there were 979 identified studies, of which 17 were selected for qualitative synthesis; 14 were included in the meta-analysis (N = 416 821). Self-reported T2DM showed a pooled relative risk (RR) of 2.49 for all-cause...
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artículo
Publicado 2018
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Aims: To assess the diagnostic accuracy of four undiagnosed Type 2 diabetes mellitus risk scores accounting for erectile dysfunction status. Methods: This was a population-based cross-sectional study. Type 2 diabetes was defined according to a oral glucose tolerance test and self-reported physician diagnosis. Erectile dysfunction was defined according to the answer to the question, ‘Have you had difficulties obtaining an erection in the last 6 months?’ (yes/no). The risk scores used were the FINDRISC, LA-FINDRISC, American Diabetes Association score and the Peruvian Risk Score. A Poisson regression model was fitted to assess the association between Type 2 diabetes and erectile dysfunction. The area under the receiver-operating characteristic curve was estimated overall and by erectile dysfunction status. Results: A total of 799 men with a mean (sd) age of 48.6 (10.7) years were inclu...
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artículo
Publicado 2015
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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...
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artículo
Publicado 2015
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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%...
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artículo
Publicado 2012
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Although often viewed as an action of last resort, going on strike remains a legal and often effective option for physicians seeking labor improvements and better working conditions. Indeed, in some countries, there have been reports of strikes by physicians 1 2, followed by ensuing discussions of potential ethical implications 3–5. However, little has been said about the consequences of such a mass labor stoppage on undergraduate medical education – and those students who aspire to the profession. In Peru, physicians from the Peruvian National Social Insurance (EsSalud) went on a 33-day strike (August 7 to September 8), effectively limiting medical services to only emergency and critical care units. Furthermore, per EsSalud's labor guidelines (prepared for purposes of the strike), all academic activity within affiliated teaching hospitals was explicitly forbidden during the strike.
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artículo
Publicado 2016
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Objetivos: Determinar la frecuencia y el conocimiento de la práctica del autoexamen de mama en alumnos de los tres primeros años de la carrera de Medicina en una universidad privada de Lima, Perú. Material y métodos: Estudio transversal descriptivo en 281 estudiantes que consistió en una encuesta de once preguntas diseñadas para evaluar lafrecuencia de la práctica y el conocimiento del autoexamen de mama. Resultados: El 89,7% de los participantes había oído del autoexamen de mama; el 21,0% lo practicaba y el 41,0% de ellos lo hacía mensualmente. En términos de conocimiento, la media fue 6,8 ± 1,8 puntos; solo el 1,0% alcanzó el puntaje máximo de once puntos. Conclusiones: La práctica del autoexamen es baja; pero parece haber un conocimiento aceptable. Es importante enfocar el esfuerzo de las intervenciones en promover la práctica de este método de tamizaje temprano...
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artículo
Publicado 2013
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Objetivo: Determinar el número de habilidades auto-percibidas relacionadas a la investigación biomédica y la proporción de alumnos interesados en dedicar su carrera a la investigación, e identificar los factores asociados a este interés en estudiantes de medicina del primer año de una universidad privada de Lima, Perú. Material y métodos: Se realizó un estudio transversal analítico en estudiantes de medicina del primer año de la Universidad Peruana Cayetano Heredia, matriculados en el 2011. Se usó un cuestionario auto-aplicado, anónimo, validado por expertos y previamente probado, se preguntó sobre las habilidades para la investigación que los alumnos consideraban tener y la intención de dedicar su carrera a la investigación. Resultados: La proporción de respuesta fue del 100% (143 estudiantes). La mediana del número de habilidades auto-percibidas fue de 2,0 (de 7,0 p...
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artículo
Publicado 2020
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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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artículo
Aim: Metabolic syndrome increases the risk of diabetes and cardiovascular disease. Recent studies on the prevalence of metabolic syndrome in Peru have focused on specific populations without national representativeness. Material and Methods: Cross-sectional analysis of a national health survey. Metabolic syndrome was defined according to the criteria of the National Cholesterol Education Program Adult Treatment Panel III (NCEP ATP III) and the International Diabetes Federation (IDF). The prevalence of metabolic syndrome was described according to sociodemographic variables, as well as its most frequent individual components and their predicted cardiovascular risk. Results: We included 917 participants aged 18-59 years. The prevalence of metabolic syndrome was 46% according to the NCEP ATP III criteria and 57% according to the IDF criteria. According to both criteria, prevalence of metabo...
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artículo
Publicado 2020
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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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artículo
Publicado 2022
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Global targets to reduce salt intake have been proposed, but their monitoring is challenged by the lack of population-based data on salt consumption. We developed a machine learning (ML) model to predict salt consumption at the population level based on simple predictors and applied this model to national surveys in 54 countries. We used 21 surveys with spot urine samples for the ML model derivation and validation; we developed a supervised ML regression model based on sex, age, weight, height, and systolic and diastolic blood pressure. We applied the ML model to 54 new surveys to quantify the mean salt consumption in the population. The pooled dataset in which we developed the ML model included 49,776 people. Overall, there were no substantial differences between the observed and ML-predicted mean salt intake (p<0.001). The pooled dataset where we applied the ML model included 166,677 p...
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artículo
Publicado 2018
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Objective: To determine the association between consumption of snacks and sweetened beverages and risk of overweight among children. Design: Secondary analysis of the Young Lives cohort study in Peru. Setting: Twenty sentinel sites from a total of 1818 districts available in Peru. Subjects: Children in the younger cohort of the Young Lives study in Peru, specifically those included in the third (2009) and the fourth (2013) rounds. Results: A total of 1813 children were evaluated at baseline; 49·2 % girls and mean age 8·0 (sd 0·3) years. At baseline, 3·3 (95 % CI 2·5, 4·2) % reported daily sweetened beverage consumption, while this proportion was 3·9 (95 % CI 3·1, 4·9) % for snacks. Baseline prevalence of overweight was 22·0 (95 % CI 20·1, 23·9) %. Only 1414 children were followed for 4·0 (sd 0·1) years, with an overweight incidence of 3·6 (95 % CI 3·1, 4·1) per 100 perso...
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informe técnico
Publicado 2017
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Proyecto de investigación 2017-2019, financiado por la Universidad Peruana de Ciencias Aplicadas (UPC).
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artículo
Publicado 2023
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Objetivo: Cuantificar la frecuencia de trastornos psiquiátricos en el ámbito ambulatorio en Perú, del 2018 al 2021. Métodos: Estudio observacional transversal utilizando información de la Superintendencia Nacional de Salud del Perú. Los diagnósticos psiquiátricos se identificaron mediante códigos de CIE-10. La frecuencia de trastornos psiquiátricos mayores se describe mediante variables demográficas. También se presentan las tendencias mensuales, así como elnúmero de visitas ambulatorias por cada 10.000 habitantes a nivel subnacional. Resultados: Entre 2018-2021, los trastornos psiquiátricos presentaron 3.142.685 visitas ambulatorias (2,3% del total) en el Perú. En todos los grupos de edad laboral, los trastornos de ansiedad y depresión representaron aproximadamente 6 de cada 10 visitas ambulatorias psiquiátricas en mujeres y 4 de cada 10 en hombres. Las tendencias...
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artículo
Publicado 2024
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Background: Examining trajectories of undernutrition and overnutrition separately limits understanding of the double burden of malnutrition. We investigated transitions between normal, stunting, overweight and concurrent stunting and overweight (CSO) and associations with sociodemographic factors in children and adolescents. Methods: We used data from the Young Lives cohort in India, Peru and Vietnam, which follow children 1-15 (N = 5413) and 8-22 years (N = 2225) over five rounds between 2002 and 2016. We estimated transitions between nutritional states using a Markov chain model and estimated sociodemographic associations employing a logit parametrization. Results: Transitions into stunting peaked in ages 1-5 years (India: 22.9%, Peru: 17.6%, Vietnam: 14.8%), while stunting reversal was highest during adolescence across all countries. Transitions into overweight peaked in ages 19-22, w...
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artículo
Publicado 2023
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Background The long-term impact of elevated blood pressure on mortality outcomes has been recently revisited due to proposed changes in cut-offs for hypertension. This study aimed at assessing the association between high blood pressure levels and 10-year mortality using the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-7) and the American College of Cardiology and the American Heart Association (ACC/AHA) 2017 blood pressure guidelines. Methods Data of the PERU MIGRANT Study, a prospective ongoing cohort, was used. The outcome of interest was 10-year all-cause mortality, and exposures were blood pressure categories according to the JNC-7 and ACC/AHA 2017 guidelines. Log-rank test, Kaplan-Meier and Cox regression models were used to assess the associations of interest controlling for confounders. Hazard ratio...
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artículo
Publicado 2019
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NCD Risk Factor Collaboration (NCD-RisC)* Abarca-Gomez, Leandra Abdeen, Ziad A Abdrakhmanova, Shynar Abdul Ghaffar, Suhaila Abdul Hamid, Zargar Abubakar Garba, Jamila Abu-Rmeileh, Niveen M Acosta-Cazares, Benjamin Adams, Robert J Aekplakorn, Wichai Afsana, Kaosar Agdeppa, Imelda A Aguilar-Salinas, Carlos A Agyemang, Charles Ahmad, Mohamad Hasnan Ahmad, Noor Ani Ahmadi, Naser Ahmadvand, Alireza Ahrens, Wolfgang Ajlouni, Kamel AlBuhairan, Fadia AlDhukair, Shahla Al-Hazzaa, Hazzaa M Ali, Mohamed M Ali, Osman Alkerwi, Ala'a Al-Othman, Amani Rashed Al-Raddadi, Rajaa Alvarez-Pedrerol, Mar Aly, Eman Amarapurkar, Deepak N Amouyel, Philippe Amuzu, Antoinette Andersen, Lars Bo Anderssen, Sigmund A Angquist, Lars H Anjana, Ranjit Mohan Ansari-Moghaddam, Alireza Aounallah-Skhiri, Hajer Araujo, Joana Ariansen, Inger Aris, Tahir Arku, Raphael E Arlappa, Nimmathota Aryal, Krishna K Aspelund, Thor Assah...
