Self-Medication Practices, Use of Brand-Name, and Over-the-Counter Medicines by Peruvian Older Adults

Background Older adults are a particularly vulnerable group to drug use and self-medication. The aim of the study was to evaluate self-medication as a factor associated with the purchase of brand-name and over-the-counter (OTC) drugs in older adults in Peru. Methods A secondary analysis was performed using an analytical cross-sectional design of data from a nationally representative survey from 2014 to 2016. The exposure variable was self-medication, defined as the purchase of medicines without a prescription. The dependent variables were purchases of brand-name and OTC drugs, both as a dichotomous response (yes/no). Information of sociodemographic variables, health insurance, and the types of drugs purchased by the participants was collected. Crude prevalence ratios (PR) were calculated and adjusted using generalized linear models of the Poisson family, considering the complex sample of the survey. Results In this study, 1,115 respondents were evaluated, with a mean age of 63.8 years and a male proportion of 48.2%. The prevalence of self-medication was 66.6%, while the proportions of purchases of brand-name and OTC drugs were 62.4% and 23.6%, respectively. The adjusted Poisson regression analysis revealed an association between self-medication and the purchase of brand-name drugs (adjusted PR [aPR]=1.09; 95% confidence interval [CI]: 1.01–1.19). Likewise, self-medication was associated with the purchase of OTC medications (aPR=1.97; 95%CI: 1.55–2.51). Conclusions This study evidenced a high prevalence of self-medication in Peruvian older adults. Two-thirds of the surveyed people bought brand-name drugs, whereas one-quarter bought OTC drugs. Self-medication was associated with a greater likelihood of buying brand-name and OTC drugs

Consumption of Herbal Supplements or Homeopathic Remedies to Prevent COVID-19 and Intention of Vaccination for COVID-19 in Latin America and the Caribbean

Users of complementary and alternative medicine (CAM) have a lower intention to receive vaccines. Furthermore, Latin America and the Caribbean (LAC) region are among the most affected areas by the COVID-19 pandemics and present a high proportion of CAM users. Therefore, this study evaluates the association between the consumption of herbal supplements or homeopathic remedies to prevent COVID-19 and the intention to vaccinate against COVID-19 in the LAC region. We conducted a secondary data analysis of a Massachusetts Institute of Technology (MIT) survey with Facebook to assess COVID-19 beliefs, behaviours, and norms. Crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI) were calculated using generalized linear models of the Poisson family with the log link function. The prevalence of the use of products to prevent COVID-19 was the following: consumption of herbal supplements (7.2%), use of homeopathic remedies (4.8%), and consumption of garlic, ginger, and lemon (11.8%). An association was found between using herbal supplements (19.0% vs. 12.8%; aPR = 1.44; 95% CI: 1.30–1.58), the use of homeopathic remedies (20.3% vs. 12.3%; aPR = 1.58; 95% CI: 1.25–1.98), and the consumption of garlic, ginger, and lemon (18.9% vs. 11.9%; aPR = 1.55; 95% CI: 1.50–1.61) and non-intention to vaccinate against COVID-19. In the LAC population, there is an association between using herbal supplements, using homeopathic remedies and consuming garlic, ginger, and lemon to prevent infection by COVID-19 and non-intention to vaccinate against this disease. Therefore, it is necessary to design targeted strategies for groups that consume these products as preventive measures against COVID-19 to increase vaccination coverage and expand the information regarding transmission and prevention strategies for SARS-CoV-2.Revisión por pare

Modelo predictivo de hipoglucemia neonatal en un hospital público del norte del Perú: Estudio de casos y controles

Introduction. Neonatal hypoglycemia is the most common and early metabolic disorder of the newborn, which can cause everything from transient irritability to states of seizure, apnea and death. The objective was to determine the risk factors associated with hypoglycemia in term newborns in a public hospital in northern Peru by creating a predictive model using logistic regression. Material and methods: The study presented a 1:1 paired case-control design, with a sample of 58 cases and 58 controls, based on the presence or absence of neonatal hypoglycemia. Maternal and neonatal variables were analyzed: gestational age, weight of the newborn, sex of the newborn, type of delivery, use of steroids, induction of labor, being the child of a diabetic mother, intrauterine growth restriction (IUGR), mother with pre-birth hydroelectrolytic disorder, meconium aspiration syndrome, and perinatal stress. Results: In multivariate analysis, child born to a diabetic mother was observed to be a risk factor for the development of neonatal hypoglycemia (OR 4.08, 95% CI 1.31-14.18, p=0.02). Conclusion: There is a significant association between being a child of a diabetic mother and developing neonatal hypoglycemia.Introducción. La hipoglucemia neonatal es el trastorno metabólico más frecuente y precoz del recién nacido, que puede causar desde irritabilidad transitoria hasta estados de convulsión, apnea y muerte. Objetivo: Identificar los factores de riesgo asociados a hipoglucemia en neonatos a término en un hospital público del norte del Perú mediante la creación de un modelo predictivo utilizando regresión logística. Material y métodos: El estudio presentó un diseño de casos y controles pareado por sexo 1:1, con una muestra de 58 casos y 58 controles, según la presencia o no de hipoglucemia neonatal. Se analizaron variables maternas y neonatales: edad gestacional, peso del recién nacido, sexo del recién nacido, tipo de parto, uso de corticoides, inducción del parto, ser hijo de madre diabética, retraso en el crecimiento intrauterino (RCIU), madre con trastorno hidroelectrolítico previo al parto, síndrome de aspiración meconial y estrés perinatal. Resultados: En el análisis multivariado, se observó que el ser hijo de madre diabética es un factor de riesgo para el desarrollo de hipoglucemia neonatal (OR 4,08, IC95% 1,31-14,18, p=0,02). Conclusión: Existe una asociación significativa entre ser hijo de madre diabética y desarrollar hipoglucemia neonatal

Efficacy and Safety of Colchicine in Post-acute Myocardial Infarction Patients : A Systematic Review and Meta-Analysis of Randomized Controlled Trials

Background: Inflammation plays a key role in atherosclerotic plaque destabilization and adverse cardiac remodeling. Recent evidence has shown a promising role of colchicine in patients with coronary artery disease. We evaluated the efficacy and safety of colchicine in post-acute myocardial infarction (MI) patients. Methods: We searched five electronic databases from inception to January 18, 2021, for randomized controlled trials (RCTs) evaluating colchicine in post-acute MI patients. Primary outcomes were cardiovascular mortality and recurrent MI. Secondary outcomes were all-cause mortality, stroke, urgent coronary revascularization, levels of follow-up high-sensitivity C-reactive protein (hs-CRP), and drug-related adverse events. All meta-analyses used inverse-variance random-effects models. Results: Six RCTs involving 6,005 patients were included. Colchicine did not significantly reduce cardiovascular mortality [risk ratio (RR), 0.91; 95% confidence interval (95% CI), 0.52-1.61; p = 0.64], recurrent MI (RR, 0.87; 95% CI, 0.62-1.22; p = 0.28), all-cause mortality (RR, 1.06; 95% CI, 0.61-1.85; p = 0.78), stroke (RR, 0.28; 95% CI, 0.07-1.09; p = 0.05), urgent coronary revascularization (RR, 0.46; 95% CI, 0.02-8.89; p = 0.19), or decreased levels of follow-up hs-CRP (mean difference, −1.95 mg/L; 95% CI, −12.88 to 8.98; p = 0.61) compared to the control group. There was no increase in any adverse events (RR, 0.97; 95% CI, 0.89-1.07; p = 0.34) or gastrointestinal adverse events (RR, 2.49; 95% CI, 0.48-12.99; p = 0.20). Subgroup analyses by colchicine dose (0.5 vs. 1 mg/day), time of follow-up (30 days) showed no changes in the overall findings. Conclusion: In post-acute MI patients, colchicine does not reduce cardiovascular or all-cause mortality, recurrent MI, or other cardiovascular outcomes. Also, colchicine did not increase drug-related adverse event

Anemia infantil en poblaciones residentes en diferentes altitudes geográficas de Arequipa, Perú: factores maternos asociados

Objective: Determine the relationship between socio-demographic characteristics, knowledge, and good practices in anemic children and anemic child healthcare in Arequipa, Peru. Study design:  This is a cross-sectional survey. Participants were asked about their knowledge of childhood anemia, practices related to caring for anemic children, and adherence to treatment. Methods: This is a descriptive, transversal, relational field study. Three hundred mothers with anemic children were interviewed, from six districts of Arequipa, distributed at different geographic altitudes: medium-altitude, great-altitude, and sea level. Studied variables were related to socio-demographic factors, level of knowledge, anemic children care-related practices, and treatment adherence.  Results: 77.3% of children had mild anemia, 21.6% moderate, and 1% severe anemia. The number of children and disease severity were significantly related (p<0.05) to knowledge about anemia. Knowledge about anemia, living area, and geographic altitude were significantly correlated (p<0.05) with good practices in child anemia. Conclusion: the prevalence of anemia in the region of Arequipa is incremented by socio-economic factors, mother’s education, number of children, altitude, and geographic zone. The implementation of mother-centered educational programs by the government is necessary. In this sense, the results suggest further studies in social representations to understand, analyze and deepen the knowledge of the subject.Objetivo: Determinar la relación entre las características sociodemográficas, conocimientos y buenas prácticas en anemia infantil y la atención al niño anémico en Arequipa, Perú. Diseño del estudio: Se trata de una encuesta transversal. Se preguntó a los participantes sobre su conocimiento sobre la anemia infantil, las prácticas relacionadas con el cuidado de los niños anémicos y la adherencia al tratamiento. Métodos: Se trata de un estudio de campo, descriptivo, transversal, relacional. Se entrevistaron 300 madres con niños anémicos, de seis distritos de Arequipa, distribuidos en diferentes altitudes geográficas: mediana, gran y nivel del mar. Las variables estudiadas se relacionaron con factores sociodemográficos, nivel de conocimiento, prácticas relacionadas con el cuidado del niño anémico y adherencia al tratamiento. Resultados: El 77,3% de los niños presentaron anemia leve, el 21,6% moderada y el 1% anemia severa. El número de hijos y la gravedad de la enfermedad se relacionaron significativamente (p<0,05) con el conocimiento sobre la anemia. Los conocimientos sobre anemia, lugar de residencia y altitud geográfica se correlacionaron significativamente (p<0,05) con las buenas prácticas en anemia infantil. Conclusión: la prevalencia de anemia en la región de Arequipa se ve incrementada por factores socioeconómicos, escolaridad de la madre, número de hijos, altitud y zona geográfica. Es necesaria la implementación de programas educativos centrados en la madre por parte del gobierno. En ese sentido, los resultados sugieren profundizar los estudios en representaciones sociales para comprender, analizar y profundizar  el conocimiento del tema

Association between self-medication with antibiotics and purchase of brand-name drugs: Analysis of a national survey in Peru

Objectives To determine the association between self-medication with antibiotics (SMA) and purchase of brand-name drugs in Peru. Methods A secondary analysis was conducted using a nationally representative survey from 2014 to 2016. The exposure variable was self-medication (SM), which is defined as the purchase of drugs for self-administration without a medical prescription. The study outcome was the purchase of brand-name drugs (yes/no). Sociodemographic variables, such as health insurance and type of institution, were considered as confounders. To assess the association between SMA and the purchase of brand-name drugs, the crude prevalence ratios (cPR) and adjusted prevalence ratios (aPR) were calculated with their confidence intervals at 95% (95% CI) using a Poisson-type generalized linear model and considering the complex survey design. Key findings A total of 1862 participants were analysed; 54.4% of the participants were women with a mean age of 39.3 years. The prevalence rate of SMA was 54.3%, whereas that of the purchase of brand-name drugs was 55.3%. The adjusted Poisson regression analysis showed an association between SMA and the purchase of brand-name drugs (aPR = 1.28; 95% CI: 1.18–1.37; P < 0.001). Conclusions It was found that 5 of 10 respondents SMA. Approximately 6 of 10 respondents that SMA used brand-name drugs. SMA is associated with a higher probability of purchasing brand-name drugs

Diagnostic performance of the GGT/HDL-C ratio for NAFLD in adults with obesity undergoing bariatric surgery

Background: Non-alcoholic fatty liver disease (NAFLD) has become the most frequent liver disease, closely related with metabolic risk factors such as obesity, insulin resistance, dyslipidemia, diabetes mellitus, and metabolic syndrome. In this context, γ-Glutamyl transpeptidase (GGT) and high-density lipoprotein cholesterol (HDL-C) have shown correlations with steatosis severity and metabolic syndrome, respectively. This positions the GGT/HDL-C ratio as a potential diagnostic indicator for NAFLD. Objective: To assess the diagnostic performance of the GGT/HDL-C ratio for NAFLD in adults with obesity undergoing bariatric surgery. Methods: We conducted an analytical cross-sectional study, designed as a diagnostic test evaluation. A secondary database of 249 adults with obesity was analyzed. The optimal cut-off point was ascertained using three methodologies, and five adjustment models were constructed for the total population, further stratified by sex. Results: The optimal cut-off point was 20.5 U/mmol and the AUC of the ratio was 0.81 (95% CI: 0.64–0.98), with sensitivity and specificity being 82.5% and 77.8%, respectively. In the overall group with an elevated GGT/HDL-C ratio, the prevalence of NAFLD increased by 14% (PR: 1.14; 95% CI: 1.04–1.33). Specifically, women displaying this altered ratio showed a 19% increased prevalence (PR: 1.19; 95% CI: 1.07–1.42) compared to those with normal values. Conclusions: The GGT/HDL-C ratio is a promising biomarker for the diagnosis of NAFLD in an adult population living with obesity.Revisión por pare

Prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19: A comparative analysis in Colombia and Peru

We aimed to estimate the prevalence and factors associated with parents’ non-intention to vaccinate their children and adolescents against COVID-19 in Colombia and Peru. We performed a secondary analysis using a database generated by the University of Maryland and Facebook (Facebook, Inc). We Included adult (18 and over) Facebook users residing in LAC who responded to the survey between May 20, and November 5, 2021. We Included sociodemographic characteristics, comorbidities, mental health, economic and food insecurity, compliance with mitigation strategies against COVID-19, and practices related to vaccination against this disease. We estimated crude (cPR) and adjusted (aPR) prevalence ratios with their respective 95 %CI. We analyzed a sample of 44,678 adults from Colombia and 24,302 from Peru. The prevalence of parents' non-intention to vaccinate their children and adolescents against COVID-19 was 7.41 % (n = 3,274) for Colombia and 6.64 % (n = 1,464) for Peru. In Colombia, age above 35 years old, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, and being vaccinated were associated with a higher probability of vaccinating children and adolescents against COVID-19. In Peru, female gender, compliance with physical distancing, use of masks, having economic insecurity, anxiety symptoms, having a chronic condition or more comorbidities, having had COVID-19, and being vaccinated were associated with a higher probability of vaccinating children against COVID-19. Living in a town, a village, or a rural area was associated with a higher prevalence of non-intention to vaccinate children and adolescents against COVID-19. About 9 out of 10 parents in Colombia and Peru intend to vaccinate their children and adolescents against COVID-19. This intention is associated with some factors which are similar between the two countries, as well as other factors and variations among the different regions of each country

Efficacy of Colchicine in the Treatment of COVID-19 Patients: A Systematic Review and Meta-Analysis

Objective: We assessed the efficacy of colchicine in COVID-19 patients through a systematic review. Methods: Six databases were searched until March 2022 for studies assessing colchicine versus control in hospitalized patients with COVID-19. The primary outcome was mortality, and secondary outcome was length of hospitalization. Inverse variance and random effect meta-analyses were performed. The strength of evidence was assessed using GRADE. Results: Nine studies (five randomized clinical trials (RCTs) and four non-randomized studies of intervention (NRSI); n = 13,478). Colchicine did not reduce mortality in comparison with the standard of care in RCTs (RR 0.99; 95%CI 0.90 to 1.10; p = 0.90); however, it did reduce mortality in NRSI studies (RR 0.45; 95%CI 0.26 to 0.77; p = 0.02). In the analysis of RCTs, colchicine did not reduce the length of hospitalization in comparison with the standard of care (MD: −2.25 days; 95%CI: −9.34 to 4.84; p = 0.15). Most studies were scored as having a high risk of bias. Quality of evidence was very low for primary and secondary outcomes. Conclusion: Colchicine did not reduce the mortality and length of hospitalization in comparison with the standard of care in hospitalized patients with COVID-19. The published evidence is insufficient and of very low quality to recommend treatment in patients with COVID-19