Impacto COVID-19 sobre relaciones factoriales, sociodemográficasobstétricas, con el estado nutricional y anemia en gestantes. Hospital II-1 EsSalud Florencia de Mora

Con el objetivo de determinar el impacto del COVID-19 sobre las relaciones entre factores sociodemográficos y obstétricos con el estado nutricional y la anemia en gestantes atendidas en el Hospital II-1 EsSalud Florencia de Mora, se realizó una investigación explicativa pre-experimental y descriptiva-correlacional. Se revisaron 113 historias clínicas entre noviembre del 2019 a abril del 2020, encontrándose que antes y durante el COVID-19 el estado nutricional era mayor entre gestantes con peso Normal y edades de 19-35 años (34,5% y 24,8% respectivamente); antes del COVID-19 el estado nutricional fue mayor entre gestantes nulíparas con Bajo peso (29,2%) y durante el COVID-19 en gestantes con estado nutricional Normal y primíparas (20,4%); antes y durante el COVID-19 la mayor proporción fueron gestantes Sin Anemia y entre 19-35 años (38,1% y 23,0% respectivamente) y; antes del COVID-19 la mayor proporción fueron gestantes Sin Anemia y primíparas (33,6%) y durante el COVID-19, la mayor fueron gestantes Sin anemia y Nulíparas (24,8%). Concluyéndose que el impacto del COVID-19 es significativo en (p<0,001) sobre las relaciones entre los factores sociodemográficos y obstétricos con el estado nutricional y la anemia deteriorase el estado nutricional e incrementado la anemia en gestantes durante la pandemia sin distinguir edades, grados de instrucción, estado civil y situación laboral o paridad, mala historia obstétrica o periodo intergenésico

Covid-19 and its repercussion on the nutritional Status and gestational Anemia from sociodemographic-obstetric factors

Introduction: Currently, the impact of COVID-19 on sociodemographic and obstetric factors, linked to nutritional status and anemia in pregnant women, represents a significant change in management and healthcare paradigms. Objectives: To consider a multiple logistic regression model and multiple comparisons (Mann-Whitney U test) based on sociodemographic-obstetric factors, nutritional status and anemia in pregnant women before and during Covid-19. Methods: In this study, 113 medical records of pregnant women attended between November 2019 and April 2020 at a Hospital II-1 in Trujillo, Peru were analyzed. Multiple logistic regression model showed a good fit and allowed to correctly classify most of pregnant women. Results: The covariates; employment situation, obstetric history, nutritional condition and anemia were significant. Differences were observed between sociodemographic factors such as employment status, obstetric factors such as obstetric history, and factors related to nutritional status and clinical symptoms of anemia. Conclusions: The impact of COVID-19 reflected in the relationships between sociodemographic and obstetric factors with nutritional status and the anemia diagnosed in pregnant women treated in a Hospital II-1 in Trujillo, Peru, was evidenced

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study

Background: The impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on postoperative recovery needs to be understood to inform clinical decision making during and after the COVID-19 pandemic. This study reports 30-day mortality and pulmonary complication rates in patients with perioperative SARS-CoV-2 infection. Methods: This international, multicentre, cohort study at 235 hospitals in 24 countries included all patients undergoing surgery who had SARS-CoV-2 infection confirmed within 7 days before or 30 days after surgery. The primary outcome measure was 30-day postoperative mortality and was assessed in all enrolled patients. The main secondary outcome measure was pulmonary complications, defined as pneumonia, acute respiratory distress syndrome, or unexpected postoperative ventilation. Findings: This analysis includes 1128 patients who had surgery between Jan 1 and March 31, 2020, of whom 835 (74·0%) had emergency surgery and 280 (24·8%) had elective surgery. SARS-CoV-2 infection was confirmed preoperatively in 294 (26·1%) patients. 30-day mortality was 23·8% (268 of 1128). Pulmonary complications occurred in 577 (51·2%) of 1128 patients; 30-day mortality in these patients was 38·0% (219 of 577), accounting for 81·7% (219 of 268) of all deaths. In adjusted analyses, 30-day mortality was associated with male sex (odds ratio 1·75 [95% CI 1·28–2·40], p\textless0·0001), age 70 years or older versus younger than 70 years (2·30 [1·65–3·22], p\textless0·0001), American Society of Anesthesiologists grades 3–5 versus grades 1–2 (2·35 [1·57–3·53], p\textless0·0001), malignant versus benign or obstetric diagnosis (1·55 [1·01–2·39], p=0·046), emergency versus elective surgery (1·67 [1·06–2·63], p=0·026), and major versus minor surgery (1·52 [1·01–2·31], p=0·047). Interpretation: Postoperative pulmonary complications occur in half of patients with perioperative SARS-CoV-2 infection and are associated with high mortality. Thresholds for surgery during the COVID-19 pandemic should be higher than during normal practice, particularly in men aged 70 years and older. Consideration should be given for postponing non-urgent procedures and promoting non-operative treatment to delay or avoid the need for surgery. Funding: National Institute for Health Research (NIHR), Association of Coloproctology of Great Britain and Ireland, Bowel and Cancer Research, Bowel Disease Research Foundation, Association of Upper Gastrointestinal Surgeons, British Association of Surgical Oncology, British Gynaecological Cancer Society, European Society of Coloproctology, NIHR Academy, Sarcoma UK, Vascular Society for Great Britain and Ireland, and Yorkshire Cancer Research

Ruralidad y campesinado

¿Existe aún el campo? ¿Desapareció el campesinado? ¿Triunfó la expansión del modo de vida urbano y de los urbanistas? ¿Subsiste aún un modo de vida rural? ¿Existe aún una cultura campesina? ¿Cuáles son las tensiones y principales amenazas que recorren el mundo rural latinoamericano? ¿Cuáles son las formas de resistencia desde la identidad campesina e indígena a la marea globalizante? ¿Qué experiencias promisorias y/ o exitosas se están desplegando en el mundo rural? ¿Cómo se ha transformado la ruralidad en las últimas décadas? ¿Cómo se enlaza la producción agraria con la emergencia de territorios intermedios? son algunas de las muchas preguntas que abordamos en este número de Polis