“Background: Booster doses have been described as effective in reducing hospitalizations and deaths from the new variants. However, its coverage is heterogeneous in Latin America and the Caribbean (LAC), one of the regions most affected by the pandemic. We aimed to assess the factors associated with not receiving a coronavirus disease 2019 (COVID-19) vaccine booster dose in adults from LAC. Methods: We analyzed a secondary database compiled by the University of Maryland and Facebook assessing the global impact of COVID-19. We included Facebook users over 18 years of age who resided in LAC and responded to the survey between February 13, 2022, and March 14, 2022. We evaluated sociodemographic characteristics, comorbidities, food, and economic insecurity, mental health, and vaccination-related practices. We calculated crude (cPR) and adjusted (aPR) prevalence ratios with their respective...

“Background: Booster doses have been described as effective in reducing hospitalizations and deaths from the new variants. However, its coverage is heterogeneous in Latin America and the Caribbean (LAC), one of the regions most affected by the pandemic. We aimed to assess the factors associated with not receiving a coronavirus disease 2019 (COVID-19) vaccine booster dose in adults from LAC. Methods: We analyzed a secondary database compiled by the University of Maryland and Facebook assessing the global impact of COVID-19. We included Facebook users over 18 years of age who resided in LAC and responded to the survey between February 13, 2022, and March 14, 2022. We evaluated sociodemographic characteristics, comorbidities, food, and economic insecurity, mental health, and vaccination-related practices. We calculated crude (cPR) and adjusted (aPR) prevalence ratios with their respective...

Introducción: El cáncer de cuello de útero, es el cuarto cáncer más común en el mundo y una de las causas de muerte por cáncer en mujeres más frecuentes en el mundo. No obstante, esta cifra se agudiza en países de bajos y medianos ingresos. Esta situación podría ser peor incluso debido al sistema de salud fragmentado que presenta nuestro país, por lo cual, es relevante explorar esta problemática. El objetivo del estudio fue evaluar los factores de riesgo para mortalidad en las pacientes diagnosticadas con cáncer de cuello de útero en el Hospital Nacional Adolfo Guevara Velasco (HNAGV) entre 2007 a 2017. Metodología: Se realizó un estudio de cohorte retrospectiva empleando las fichas de recolección de datos del HNAGV y las historias clínicas de las pacientes diagnosticadas con cáncer de cuello de útero entre 2007 a 2017. La población de estudio fueron las mujeres dia...

Background: Irresponsible self-medication is a problem for health systems in developing countries. We aimed to estimate the frequency of self-medication and associated factors in users of drugstores and pharmacies in Peru. Methods: We performed a secondary data analysis of the 2015 National Survey on User Satisfaction of Health Services (ENSUSALUD), a two-stage probabilistic sample of all regions of Peru. Non self-medication (NSM), responsible self-medication (RSM) and irresponsible self-medication (ISM) were defined as the outcome categories. Demographic, social, cultural and health system variables were included as covariates. We calculated relative prevalence ratios (RPR) with their 95% confidence intervals (95%CI) using crude and adjusted multinomial logistic regression models for complex samples with NSM as the referent category. Results: 2582 participants were included. The average...

Background Research is an important undergraduate competence for physicians. However, few studies have assessed the scientific production of medical students in Latin-America. Thus, this study had the objective to assess the rate and characteristics of research publications by undergraduate medical students in 2016, in Lima, Peru. Methods This cross-sectional study included all the students of the eight medical schools in Lima (Peru). The medical students included were collected from the registry of the National Medical Examination (taken during their last year of undergraduate studies) in 2016. To evaluate their research publications, systematic searches were performed in Google Scholar and PubMed during August 2018. Results We studied data from 1241 medical students (54.2% females) from eight medical schools. 173 (13.9%) students published at least one paper, 102 (8.2%) published at le...

La medicina basada en evidencias (MBE) es definida como el uso consciente, explícito y juicioso de la mejor evidencia científica disponible para la toma de decisiones sobre los pacientes. Este término ha cobrado popularidad en los últimos años y se ha posicionado como una de las tendencias más aceptadas para la práctica médica. Para que un médico pueda realizar la MBE necesita reunir distintas competencias como la búsqueda bibliográfica, lectura crítica (tanto metodológica como estadística) de artículos científicos y razonamiento clínico para brindar al paciente el mejor cuidado de acuerdo con la evidencia encontrada.

Los desórdenes mentales son un problema prioritario de salud pública, de manera que su prevalencia mundial se calcula en 17,6%, y se estima que el 22,9% de años vividos con discapacidad a nivel mundial se deben a desórdenes mentales y abuso de sustancias. Para afrontar esta situación, resulta necesario que los sistemas de salud dispongan de personal capacitado en el diagnóstico y manejo de estas condiciones, que incluye el manejo de psicoterapia básica. De esta manera, un metaanálisis refiere que el entrenamiento en psicoterapia del personal de salud no especializado es efectivo en el primer nivel de atención, reduciendo los desórdenes mentales perinatales en mujeres y el riesgo de padecer depresión en adultos hasta en 60%, siendo potencialmente efectivo para otros desórdenes mentales. Coherentemente, la normativa peruana refiere que los encargados de realizar el diagnóstico...

Background: Physical performance in the older adult has been extensively studied. However, only a few studies have evaluated physical performance among older adults of high Andean populations and none have studied the factors associated with it. The objective of this study was to evaluate factors associated with poor physical performance by using the Short Physical Performance Battery (SPPB) in older adults living in 11 Peruvian high Andean communities. Methods: An analytical cross-sectional study was carried out in inhabitants aged 60 or over from 11 high-altitude Andean communities of Peru during 2013-2017. Participants were categorized in two groups according to their SPPB score: poor physical performance (0-6 points) and medium/good physical performance (7-12 points). Additionally, we collected socio-demographic, medical, functional and cognitive assessment information. Poisson regre...

Aim: To evaluate the association between vitamin D deficiency and insulin resistance (IR) or hyperinsulinemia after oral glucose tolerance test (OGTT) in euthyroid non-diabetic individuals. Materials and methods: We carried out an analytical cross-sectional study in euthyroid non-diabetic adults of both sexes, who attended the outpatient service of a private clinic in Lima-Peru during the 2012e2016 period. Participants were categorized in two groups according to their serum vitamin D levels: normal vitamin D levels (serum vitamin D values 20 ng/dL) and vitamin D deficiency (serum vitamin D values < 20 ng/dL). IR was defined as a Homeostasis Model Assessment (HOMA-IR) value 3.8 and hyperinsulinemia after OGTT was defined as a serum insulin value 80mU/mL after 120min of 75-g glucose intake. We elaborated crude and adjusted Poisson regression models to assess the association between serum v...

Aim: To assess the association between elevated waist circumference (WC)and high waist-to-height ratio (WHtR)with insulin resistance biomarkers. Methods: We conducted an analytical cross-sectional study in normal-weight adults. Participants were divided in two groups according to WC or WHtR levels. We considered values of WC ≥ 90 in male participants and WC ≥ 80 in adult women as elevated, and values of WHtR≥0.50 as high, for both genders. Our outcomes were high triglycerides to HDL-cholesterol (TG/HDL-C)ratio and elevated triglycerides and glucose index (TGI). We considered values of TG/HDL-C ratio ≥ 3 as high and TGI values ≥ 8.37 as elevated. We elaborated crude and adjusted Poisson generalized linear models to evaluate the proposed associations and explored the gender interaction using stratified models. We reported the prevalence ratio (PR)with their respective 95% confide...

Aim: To evaluate the risk factors for poor functional prognosis in patients hospitalized for spontaneous intracerebral hemorrhage. Methods: A retrospective cohort study was carried out where 73 patients with a diagnosis of intracerebral hemorrhage were included in a reference hospital in Peru from 2020 to 2022. The clinical history was used, which included demographic, clinical, laboratory and imaging data. Associations between qualitative variables and the incidence of poor functional outcome and mortality were established using Pearson's chi-square test, crude relative risks (RRc) with 95% confidence intervals were used, and a Poisson linear model with a function was applied. log link and robust variances. Results: 66.7% experienced poor functional outcome, the associated factors were: previous cerebrovascular disease, Glasgow Coma Scale on admission from 3 to 8, leukocyte level, early...

The objective of this cross-sectional study was to determine the prevalence of post-stroke rehabilitation devices offered via the Internet whose efficacy was proven in an RCT and factors associated with this prevalence.

Objectives. To evaluate the association between allergic rhinitis and the degree of pulmonary involvement in patients with COVID-19 and to determine the frequencies of the main variables. Materials and methods. An observational, cross-sectional and analytical study was carried out by reviewing the medical records of patients diagnosed with COVID-19 from the Cayetano Heredia National Hospital between 2020 and 2021. We obtained information regarding the history of allergic rhinitis; pulmonary involvement was assessed by non-contrast tomography results using the chest computed tomography (CT) score. Data regarding sociodemographic and clinical variables was also obtained. Both crude (PR) and adjusted (aPR) prevalence ratios with their respective 95% confidence intervals (CI) were estimated. We also used a generalized linear Poisson family model with log link function and robust variances. R...

Objectives: to estimate the role of maternal overweight and obesity before pregnancy as predictors of childhood asthma in a population of Peruvian children under five years. Methods: we carried out a retrospective cohort study of children aged five years or less and their mothers from the Regional Hospital of Ayacucho and the María Auxiliadora Hospital in Lima, Peru. We included children who were born between 2013 and 2014 and follow them up until 2018 and 2019, respectively. The diagnosis of overweight and obesity of the mother before pregnancy and asthma in the child were registered in their clinical histories. Crude (cRR) and adjusted relative risks (aRR) and 95% confidence intervals (CI95%) were obtained using a generalized linear model of the Poisson family with link log and robust variances. Results: We evaluated 431 medical records and found that 20.9% of the children had asthma,...

In 2013, there were 25.7 million stroke survivors and 6.5 million stroke-related deaths. Previous studies have indicated that approximately 40% of stroke survivors remain with functional impairments and need physical rehabilitation. However, many barriers could limit access to continuous physical rehabilitation for these patients, so devices that complement or assist in the rehabilitation process can be of great help. The quality, safety and efficacy of medical devices should be evaluated in randomized controlled trials (RCTs). However, the efficacy of many medical devices entering the market in the United States and the European Union (EU) has not been evaluated. Unproven post-stroke rehabilitation devices could be useless or even harmful to patients, thereby increasing healthcare costs. Previous studies have found that post-stroke rehabilitation devices without a rigorous evidence base...

Objective: To describe the clinical and demographic characteristics of patients with acute cerebral infarction treated at a national reference hospital in Peru and determine the risk factors for inhospital complications. Methods: We conducted a retrospective cohort study including 192 patients with acute ischemic stroke in a national reference hospital in Peru from January to September 2021. Clinical, demographic and paraclinical information was recorded from medical records. We estimated risk ratios and 95% confidence intervals using regression models with Poisson family and robust variance for the bivariate and multivariate model, adjusting for age, sex and risk factors for stroke. Results: At least one in-hospital complication occurred in 32.3% of the patients. The most frequent complications were infectious in 22.4%, followed by 17.7% of neurological complications, with other complic...

Objective: To describe the clinical and demographic characteristics of patients with acute cerebral infarction treated at a national reference hospital in Peru and determine the risk factors for inhospital complications. Methods: We conducted a retrospective cohort study including 192 patients with acute ischemic stroke in a national reference hospital in Peru from January to September 2021. Clinical, demographic and paraclinical information was recorded from medical records. We estimated risk ratios and 95% confidence intervals using regression models with Poisson family and robust variance for the bivariate and multivariate model, adjusting for age, sex and risk factors for stroke. Results: At least one in-hospital complication occurred in 32.3% of the patients. The most frequent complications were infectious in 22.4%, followed by 17.7% of neurological complications, with other complic...

Objective: To describe the clinical and demographic characteristics of patients with acute cerebral infarction treated at a national reference hospital in Peru and determine the risk factors for inhospital complications. Methods: We conducted a retrospective cohort study including 192 patients with acute ischemic stroke in a national reference hospital in Peru from January to September 2021. Clinical, demographic and paraclinical information was recorded from medical records. We estimated risk ratios and 95% confidence intervals using regression models with Poisson family and robust variance for the bivariate and multivariate model, adjusting for age, sex and risk factors for stroke. Results: At least one in-hospital complication occurred in 32.3% of the patients. The most frequent complications were infectious in 22.4%, followed by 17.7% of neurological complications, with other complic...

The incidence of intussusception is 2.5 per 1000 live births, and infants between 4 and 10 months of age represent the highest frequency peak. Cases of intussusception with acute COVID-19 infection have been reported in infants under one year of age and with one death associated with MIS-C. However, we have not found reports of intussusception in schoolchildren. We report the case of a 6-year-old male with two days of illness that began with a sensation of temperature rise, headache, abdominal pain, liquid stools with mucus and no blood, hyporexia, chills, and food vomiting. He presented a negative result for the detection of SARS-CoV-2 antigen, negative SARS-CoV-2 IgM/IgG serology positive (lateral flow immunochromatography test), in addition to total IgM/IgG antibodies in 11.88 COI by means of a test of electrochemiluminescence. An abdominal ultrasound was performed that concluded inva...

“Objective To assess the association between inadequate prenatal care (IPNC) and Low birth weight (LBW) in newborns of singleton gestation mothers in Peru. Methods We performed a secondary analysis of data from the 2019 Demographic and Health Survey. We included a total of 10,186 women of reproductive age (15 – 49 years) who had given birth to a singleton child in the last 5 years. The dependent variable was LBW (< 2500 g). The independent variables were IPNC (inadequate: when at least one of the IPNC components was absent [number of PNC visits ≥ 6, first PNC visit during the first trimester, compliance with PNC visit contents, and PNC visits provided by trained health personnel]) and each of its components. We evaluated the association using logistic regression models to estimate crude odds ratios and adjusted odds ratios (aOR) and their respective 95% confidence intervals (95% CI...