Resistencia bacteriana y factores asociados en pacientes con pie diabético infectado sin desenlace de amputación mayor en un hospital nacional peruano

Objective: To determine the relationship between maternal anemia in the first trimester of pregnancy and low birth weight in four mother-and-child-health centers in Southern Lima during 2019. Material and methods: A retrospective cohort study from a secondary database was performed, where pregnant women from 4 middle-complexity Health Centers from Southern Lima were included. Deliveries took place during 2019, excluding preterm newborns. First trimester hemoglobin concentration <11 g/dL was defined as anemia and birth weight <2500 g was defined as low birth weight. Cumulative incidence for anemia was calculated, and relative risk (RR) adjusted for potential confounders was also calculated. Results: Two hundred and twenty one pregnant women were included. Seventy-six per cent were between 18 and 35 years old. Forty-two percent were primigravida, fifty-two percent had excess body wei...

Aims The objective of this systematic review and meta-analysis is to estimate the prevalence and incidence of diabetic peripheral neuropathy (DPN) in Latin America and the Caribbean (LAC). Materials and methods We searched MEDLINE, SCOPUS, Web of Science, EMBASE and LILACS databases of published observational studies in LAC up to December 2020. Meta-analyses of proportions were performed using random-effects models using Stata Program 15.1. Heterogeneity was evaluated through sensitivity, subgroup, and meta-regression analyses. Evidence certainty was performed with the GRADE approach. Results Twenty-nine studies from eight countries were included. The estimated prevalence of DPN was 46.5% (95%CI: 38.0-55.0) with a significant heterogeneity (I2 = 98.2%; p<0.01). Only two studies reported incidence, and the pooled effect size was 13.7% (95%CI: 10.6-17.2). We found an increasing trend of cu...

Objective: To determine the relationship between maternal anemia in the first trimester of pregnancy and low birth weight in four mother-and-child-health centers in Southern Lima during 2019. Material and methods: A retrospective cohort study from a secondary database was performed, where pregnant women from 4 middle-complexity Health Centers from Southern Lima were included. Deliveries took place during 2019, excluding preterm newborns. First trimester hemoglobin concentration <11 g/dL was defined as anemia and birth weight <2500 g was defined as low birth weight. Cumulative incidence for anemia was calculated, and relative risk (RR) adjusted for potential confounders was also calculated. Results: Two hundred and twenty one pregnant women were included. Seventy-six per cent were between 18 and 35 years old. Forty-two percent were primigravida, fifty-two percent had excess body wei...

Resistencia bacteriana y factores asociados en pacientes con pie diabético infectado sin desenlace de amputación mayor en un hospital nacional peruano

Introducción. Para aplicar un cuestionario de tamizaje en una población diferente a la original, necesita evaluarse según sus características y determinar su capacidad discriminativa. Materiales y métodos. Se realizó un estudio transversal comparándolos resultados del FINDRISC (Cuestionario Finlandés de Riesgo de Diabetes) original (FORIG) y modificado (FMOD) con valores latinoamericanos para obesidad abdominal (varón≥94 cm y mujer≥90 cm) para determinar disglicemia (incluye Glucosa Alterada en Ayunas, Intolerancia a la glucosa y Diabetes Mellitus), según Prueba de Tolerancia Oral a la Glucosa en trabajadores del Hospital María Auxiliadora. Resultados. De 549 sujetos, el 77.5% fue de sexo femenino, 70% tuvo edad > 45 años, 75% tenía IMC>25 y65.4% obesidad abdominal con criterios latinoamericanos. Se halló disglicemia en 17.8%. El Área Bajo la Curva Característica Oper...

Objective: To determine prevalence of painful asymptomatic peripheral neuropathy (PN) in persons with type 2 diabetes mellitus (DM2) and its associated characteristics. Materials and Methods: This is a cross-sectional descriptive study performed in patients belonging to the program ‘Feet at risk’ at the Endocrinology Service in Maria Auxiliadora National Hospital. Patients with DM2 who were seen between 2015 and 2020 were included. The definition of PN is according to Toronto Consensus, considering the evaluation of three components: symptoms, signs and Achilles reflex, determining certainty as possible and probable, according to the combinations found. For assessing symptoms, the total symptom score (TTS) was used; for signs, monofilament test was used, and vibration sensitivity was assessed using a 128-Hz tuning fork. Prevalence of PN was calculated according to symptoms and certai...

Objetivos: Determinar la frecuencia de pie en riesgo de ulceración según el Sistema International Working Group on the Diabetic Foot (IWGDF) y los factores asociados en pacientes con diabetes mellitus tipo 2 de un hospital general de Lima-Perú. Material y Métodos: Estudio descriptivo, transversal de información secundaria. Se revisaron 382 fichas de pacientes con diabetes mellitus tipo 2, recopiladas por el servicio de endocrinología del Hospital María Auxiliadora desde enero de 2013 a diciembre de 2015. La ficha contenía datos demográficos y examen físico que incluía evaluación de monofilamento, diapasón 128 Hz y examen de pulsos. Se utilizó el IWGDF: Grado 0 no Neuropatía Periférica (NP), Grado 1 NP; Grado 2 Enfermedad arterial periférica (EAP) y/o deformación del pie y Grado 3 antecedente de úlcera. Se analizaron los datos mediante estadística descriptiva e inferen...

Objective: To determine prevalence of painful asymptomatic peripheral neuropathy (PN) in persons with type 2 diabetes mellitus (DM2) and its associated characteristics. Materials and Methods: This is a cross-sectional descriptive study performed in patients belonging to the program ‘Feet at risk’ at the Endocrinology Service in Maria Auxiliadora National Hospital. Patients with DM2 who were seen between 2015 and 2020 were included. The definition of PN is according to Toronto Consensus, considering the evaluation of three components: symptoms, signs and Achilles reflex, determining certainty as possible and probable, according to the combinations found. For assessing symptoms, the total symptom score (TTS) was used; for signs, monofilament test was used, and vibration sensitivity was assessed using a 128-Hz tuning fork. Prevalence of PN was calculated according to symptoms and certai...

Objetivo: estimar la exactitud pronóstica para amputación de miembro inferior de las escalas de pie diabético utilizadas en estudios realizados en América Latina y el Caribe. Materiales y métodos: se incluyó a estudios longitudinales sin restricción de idioma provenientes de Scielo, Embase, PubMed, Web of Science (WOS) y SCOPUS, hasta octubre de 2024. Los estudios registraron la incidencia de amputación mayor o a cualquier nivel según la aplicación de una escala de pie diabético al inicio de la atención médica. Mediante un metaanálisis se estimó la sensibilidad, especificidad, razón de verosimilitud (LR, del inglés likelihood ratio) positiva (LR+) y negativa (LR-), odds ratio diagnóstico y el área bajo la curva ROC. El riesgo de sesgo fue evaluado utilizando la herramienta QUADAS-2 y la certeza de la evidencia se analizó según GRADE. Resultados: se incluyero...

Introduction: The pandemic increased stress and underdiagnosed mental health issues in the workplace.Objetive: To determine the frequency of mental health problems and their associated factors among vaccinated workers at the Dos de Mayo National Hospital (HNDM).Methods: A cross-sectional analytical study was conducted using secondary data from a mental health survey carried out by the HNDM Mental Health Service in October 2021. The Self-Reporting Questionnaire (SRQ) was administered to all HNDM workers who had received the full vaccination scheme. Statistical analysis included chi-square tests and logistic regression to identify associated factors.Results: Of 2109 workers, 2.7% presented mental health problems, with a higher prevalence in women (3.4%) compared to men (1.5%), and more frequent in the age groups 18-29 years (4.8%) and 50-59 years (4%). Divorced/separated individuals (7...

Objective: To assess the relationship between metabolic control and peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (DM2) in Maria Auxiliadora Hospital (MAH). Material and methods: This is a sex-matched case-control study with a secondary analysis based on data from the endocrinology service of MAH, Lima, Peru. Cases with PAD were defined as those with <0.9 ankle-to-arm index (ATAI). Controls were those subjects with ATAI between 0.9 and 1.3, under a 4:1 relationship with respect to cases. Poor metabolic control was defined as follows: glycated hemoglobin ≥7%, systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, HDL cholesterol <40 mg/dL (males) or >50 mg/dL (females), LDL cholesterol ≥100 mg/dL and triglycerides ≥150 mg/dL. Odds ratio values for poor metabolic control were calculated, both crude and adjusted, according to...

Objective: To assess the relationship between metabolic control and peripheral arterial disease (PAD) in patients with type 2 diabetes mellitus (DM2) in Maria Auxiliadora Hospital (MAH). Material and methods: This is a sex-matched case-control study with a secondary analysis based on data from the endocrinology service of MAH, Lima, Peru. Cases with PAD were defined as those with <0.9 ankle-to-arm index (ATAI). Controls were those subjects with ATAI between 0.9 and 1.3, under a 4:1 relationship with respect to cases. Poor metabolic control was defined as follows: glycated hemoglobin ≥7%, systolic blood pressure ≥140 mm Hg, diastolic blood pressure ≥90 mm Hg, HDL cholesterol <40 mg/dL (males) or >50 mg/dL (females), LDL cholesterol ≥100 mg/dL and triglycerides ≥150 mg/dL. Odds ratio values for poor metabolic control were calculated, both crude and adjusted, according to...

Introducción: Las mujeres en edad reproductiva podrían considerarse como una población vulnerable a contraer la infección por VIH. La relación entre conocimiento y prácticas no está descrita en un contexto donde los conocimientos, actitudes y prácticas sobre el VIH son inadecuados. Objetivo: Determinar la asociación entre conocimientos y prácticas sobre la infección por VIH en mujeres peruanas en edad reproductiva. Material y Métodos: Análisis de Encuesta Demográfica y de Salud Familiar 2019, cuya muestra fue probabilística, estratificada y bietápica. El análisis consideró a mujeres en edad reproductiva sexualmente activas. Se definió “conocimientos adecuados” a los puntajes superiores al tercil superior de las observaciones al responder 18 preguntas y se determinó la asociación con cada una de las cinco prácticas. Se utilizó estadística descriptiva e inferenc...

Introduction: Only 3 types of coronavirus cause aggressive respiratory disease in humans (MERS-Cov, SARS-Cov-1, and SARS-Cov-2). It has been reported higher infection rates and severe manifestations (ICU admission, need for mechanical ventilation, and death) in patients with comorbidities such as diabetes mellitus (DM). For this reason, this study aimed to determine the prevalence of diabetes comorbidity and its associated unfavorable health outcomes in patients with acute respiratory syndromes for coronavirus disease according to virus types. Methods: Systematic review of literature in Pubmed/Medline, Scopus, Web of Science, Cochrane, and Scielo until April of 2020. We included cohort and cross-sectional studies with no restriction by language or geographical zone. The selection and extraction were undertaken by 2 reviewers, independently. The study quality was evaluated with Loney’s ...

Introducción. El presente artículo resume la guía de práctica clínica (GPC) para el tamizaje, evaluación de riesgo y manejo de la dislipidemia en pacientes sin enfermedad cardiovascular (ECV) establecida en el primer nivel de atención. Objetivo. Brindar a los profesionales de la salud recomendaciones basadas en la evidencia para la toma de decisiones en tamizaje, evaluación de riesgo y manejo de la dislipidemia en pacientes sin ECV establecida. Métodos. Se conformó un grupo elaborador de la guía (GEG) que incluyó médicos especialistas y metodólogos, el cual formuló preguntas clínicas en formato PICO. Se realizaron búsquedas sistemáticas de revisiones sistemáticas en las bases de datos PubMed, Embase y Cochrane Library. Se seleccionó la evidencia para responder cada una de las preguntas clínicas formuladas. Se evaluó la certeza de la evidencia usando la metodolo...