Capacidad predictiva del péptido natriurético cerebral en la insuficiencia cardiaca aguda en el Hospital Nacional Ramiro Prialé Prialé de Huancayo, 2014-2017

Según la Organización Mundial de la Salud, las cardiopatías son la principal causa de muerte en el mundo, entre ellas la Insuficiencia Cardiaca. Para el tamizaje de Insuficiencia Cardiaca se suele utilizar el Péptido Natriurético Cerebral (PNB), donde valores <100pg/ml la descartan; esta prueba es más económica que el ecocardiograma. La altitud geográfica (>1500msnm) influye en la elevación del PNB y genera cambios fisiológicos cardiovasculares. El objetivo de estudio fue determinar la capacidad predictiva del PNB en el tamizaje de Insuficiencia Cardiaca en Huancayo. La metodología comprende un estudio transversal comparativo de prueba diagnóstica. Se incluyeron pacientes adultos, con sospecha de Insuficiencia Cardiaca aguda que contaban con dosaje de PNB y ecocardiograma en un Hospital de Huancayo (3259m.s.n.m.). Se obtuvo una muestra de 29 casos y 29 controles como número mínimo de tamaño de muestra, se trabajó con 83 pacientes (45 casos y 38controles). Los resultados señalan que la población fue de 74 ± [RIQ 61-79] años. Los pacientes con síntomas característicos de Insuficiencia Cardiaca evaluados presentaron valores de PNB mayores que los asintomáticos: antecedente de EPID (p<0.001), disnea (p=0.024), fatiga (p=0.002), tos nocturna (p25rpm) (p=0.015), saturación de oxigeno baja (p=0.014), dilataciones cardiacas (p<0.001), valvulopatías, Insuficiencia Tricuspídea (p=0.010), Insuficiencia Mitral (p<0.001), Hipertensión Pulmonar (p<0.001), Cor pulmonale crónico (p=0.028). Los pacientes sin diagnóstico de Insuficiencia Cardiaca presentaron valores de PNB > 100pg/ml. El estudio concluye que en la población observamos una mayor elevación de PNB por lo que proponemos un punto de corte ≥130pg/ml, superior al propuesto por las guías actuales. La Capacidad Predictiva del PNB en Huancayo es menor a la reportada en otros estudios

Identificación de las prioridades nacionales de investigación en COVID-19 (SARS-CoV-2) y otros virus respiratorios con potencial pandémico: Descripción del proceso peruano

Research priorities are a fundamental component of national health research systems. In the year 2021, the National Institute of Health led the process of identifying the "national research priorities in COVID-19 (SARS-CoV-2) and other respiratory viruses with pandemic potential: Preparing for the next pandemic, 2022-2026”. The process was developed following the previous methodology for identification of research priorities used by the Instituto Nacional de Salud (Perú), which was to be adapted to a virtual environment, with four phases. Six strategic objectives to be achieved were formulated and served as an umbrella for the identification of national priorities, a total of 21 research priorities were identified. It is recommended that a plan for the implementation of research priorities be formulated and executed and that the Ministry of Health, through its different instances, take the necessary steps to obtain and allocate resources to the generation of evidence within the framework of priorities.Las prioridades de investigación son un componente fundamental de los sistemas nacionales de investigación en salud. En el año 2021, el Instituto Nacional de Salud lideró el proceso de identificación de las “prioridades nacionales de investigación en COVID-19 (SARS-CoV-2) y otros virus respiratorios con potencial pandémico: Preparándonos para la siguiente pandemia, 2022-2026”. El proceso siguió la metodología previamente utilizada por el Instituto Nacional de Salud (Perú) para la identificación de prioridades de identificación, la que se tuvo que adaptar a un entorno totalmente virtual, con cuatro fases. Se formularon seis objetivos estratégicos a alcanzar y que sirvieron de paraguas para la identificación de las prioridades nacionales, se identificaron en total 21 prioridades de investigación. Se recomienda se formule y ejecute un plan de implementación de las prioridades de investigación y que el Ministerio de Salud a través de sus diferentes instancias realice las gestiones necesarias para conseguir y destinar recursos a la generación de evidencia en el marco de las prioridades

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially

Global economic burden of unmet surgical need for appendicitis

Background There is a substantial gap in provision of adequate surgical care in many low- and middle-income countries. This study aimed to identify the economic burden of unmet surgical need for the common condition of appendicitis. Methods Data on the incidence of appendicitis from 170 countries and two different approaches were used to estimate numbers of patients who do not receive surgery: as a fixed proportion of the total unmet surgical need per country (approach 1); and based on country income status (approach 2). Indirect costs with current levels of access and local quality, and those if quality were at the standards of high-income countries, were estimated. A human capital approach was applied, focusing on the economic burden resulting from premature death and absenteeism. Results Excess mortality was 4185 per 100 000 cases of appendicitis using approach 1 and 3448 per 100 000 using approach 2. The economic burden of continuing current levels of access and local quality was US $92 492 million using approach 1 and$73 141 million using approach 2. The economic burden of not providing surgical care to the standards of high-income countries was $95 004 million using approach 1 and$75 666 million using approach 2. The largest share of these costs resulted from premature death (97.7 per cent) and lack of access (97.0 per cent) in contrast to lack of quality. Conclusion For a comparatively non-complex emergency condition such as appendicitis, increasing access to care should be prioritized. Although improving quality of care should not be neglected, increasing provision of care at current standards could reduce societal costs substantially