Association between the Use of Antibiotics and the Development of Acute Renal Injury in Patients Hospitalized for COVID-19 in a Hospital in the Peruvian Amazon

"Introduction: A significant antibiotic prescribing pattern associated with the COVID-19 pandemic has been described. Multiple protocols included empirical antimicrobials, leading to a substantial increase in antimicrobial consumption in medical care. A higher mortality rate is described among patients diagnosed with COVID-19 who received antibiotics. Objectives: To determine the association between the use of antibiotics and the development of acute renal injury in patients infected with SARS-CoV-2 in patients treated at the Hospital II EsSalud de Ucayali, 2021. Methods: A cross-sectionalanalytical study was conducted, evaluating the medical records of patients admitted to the intensive care unit between July 2020 and July 2021. For the statistical analysis, measures of central tendency and dispersion, statistical hypothesis contrast tests were used in relation to acute kidney injury (AKI), antibiotic use and associated factors, derived from linear regression models. Results: The factors that were positively associated with the development of AKI were sepsis (aPR: 2.86; 95% CI: 1.26–6.43), shock (aPR:2.49; 95% CI: 1.28–4.86), mechanical ventilation (aPR:9.11; 95% CI: 1.23–67.57), and use of vancomycin (aPR: 3.15; 95% CI: 1.19–8.27). Conclusions: In the Peruvian Amazon, there is a high consumption and inadequate prescription of antibiotics. The drugs most commonly used for the treatment of COVID-19 were: aminoglycosides, vancomycin, ivermectin, azithromycin, tocilizumab, and corticosteroids. The development of AKI among hospitalized patients was found to be related to vancomycin administration. In addition, an association was found with the use of mechanical ventilation, a high body mass index, and the presence of complications such as sepsis or shock. Therefore, inappropriate antibiotic use for COVID-19 has been associated with multiple negative outcomes and consequences.

"Eficacia de los programas de tratamiento para ciberadicción en niños y adolescentes: revisión sistemática y meta-análisis "

"El objetivo de este estudio fue evaluar la eficacia de los programas de tratamiento para la ciberadicción en niños y adolescentes. Material y Métodos: Se realizó la búsqueda en cinco bases de datos. Se seleccionaron ensayos controlados aleatorizados (ECA) o estudios de cohorte que evaluaron la eficacia de programas de tratamiento para la ciberadicción en niños y adolescentes. El desenlace primario fue la disminución de las horas en uso del internet. Para el meta-análisis, se utilizó el modelo de efectos aleatorios con método de varianza inversa. Resultados: Se identificaron siete artículos que fueron incluidos en la revisión sistemática (3 Ensayos controlados aleatorizados y 4 cohortes retrospectivas), con un total de 2396 participantes. La edad media fue de 14 años (SD 1.96). La duración del tratamiento entre todos los estudios publicados varió entre 4 días hasta los 3 meses. Se encontró que los tratamientos para la ciberadicción reducen las horas de conexión a internet en 1.18 horas por semana, comparado con cualquier tratamiento de control (MD 1.18; 95%CI -2.1825 a -0.1754; p= 0.02). Conclusiones: Los tratamientos para la ciberadicción, independientemente del tipo de intervención reducen las horas de conexión a internet

Arbovirosis y Viruela del Mono - ¿Un diagnóstico diferencial de solapamiento epidemiológico?

Editorial (no abstract)Editorial (Sin resumen

Mean Platelet Volume in Neonatal Sepsis: Meta-Analysis of Observational Studies

"first_pagesettingsOrder Article Reprints Open AccessSystematic Review Mean Platelet Volume in Neonatal Sepsis: Meta-Analysis of Observational Studies by Carlos J. Toro-Huamanchumo 1ORCID,Cielo Cabanillas-Ramirez 2,3ORCID,Carlos Quispe-Vicuña 3,4ORCID,Jose A. Caballero-Alvarado 5ORCID,Darwin A. León-Figueroa 3,6ORCID,Nicolás Cruces-Tirado 7 andJoshuan J. Barboza 3,8,*ORCID 1 Escuela de Medicina, Universidad Cesar Vallejo, Trujillo 13007, Peru 2 Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas, Lima 15023, Peru 3 Unidad de Revisiones Sistemáticas y Meta-Análisis, Tau-Relaped Group, Trujillo 13007, Peru 4 Sociedad Científica San Fernando, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru 5 Facultad de Medicina, Universidad Privada Antenor Orrego, Trujillo 13007, Peru 6 Facultad de Medicina Humana, Universidad de San Martín de Porres, Chiclayo 14000, Peru 7 Facultad de Ciencias de la Salud, Universidad Señor de Sipán, Chiclayo 14006, Peru 8 Vicerrectorado de Investigación, Universidad Norbert Wiener, Lima 15046, Peru * Author to whom correspondence should be addressed. Children 2022, 9(12), 1821; https://doi.org/10.3390/children9121821 Received: 5 October 2022 / Revised: 21 November 2022 / Accepted: 22 November 2022 / Published: 25 November 2022 (This article belongs to the Section Pediatric Infectious Diseases) Download Browse Figures Review Reports Versions Notes Abstract Introduction: Early onset neonatal sepsis (EONS), particularly in preterm sepsis, is a potentially fatal issue. Evaluation of mean platelet volume (MPV) as an EONS predictor was the goal. Methods: Four databases were used to conduct a systematic evaluation of cohort and case–control studies. Up till the end of October 2022, 137 articles were found utilizing the search method. Following the review, 12 studies were included. Leukocytes, MPV, platelets, gender, birth weight, gestational age, mortality, and C-reactive protein (CRP) were all taken into account while analyzing the prediction of EONS. Inverse-variance methodology and the random-effects model were used. Using GRADE, the evidence’s quality was evaluated. Results: Neonatal patients with sepsis had significantly higher MPV levels than do neonates without sepsis (MD 1.26; 95% CI 0.89–1.63; p < 0.001). An increased MPV during the first 24 h postpartum was associated with high CRP values and high risk of neonatal mortality. In the investigations, the MPV cutoff for sepsis patients was 9.95 (SD 0.843). Overall certainty of the evidence was very low. Conclusions: The increased MPV during the first 24 h postpartum may be predictive of EONS and mortality. Future studies are warranted.

Supervivencia en pacientes con COVID-19 ingresados en UCI en un hospital de tercer nivel de Lambayeque, Perú.

Introduction: COVID-19, caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has reached pandemic proportions worldwide, persisting over time. In this context, this study aims to analyze the factors associated with mortality in hospitalized patients with COVID-19 in a third-level hospital in the Lambayeque region. Material and metodo: A retrospective cohort study was conducted on patients diagnosed with COVID-19, hospitalized at the National Hospital Almanzor Aguinaga Asenjo (HNAAA) during the months of March to September 2020. Results: Forty patients admitted to the Intensive Care Unit (ICU) were examined, of whom twenty-two required mechanical ventilation (MV). Overall mortality in the ICU was 68.7%, while mortality among patients who required mechanical ventilation was 91.6%. A statistical association was found between death and vital signs on admission to the ICU, as well as with the waiting time for admission. The probability of survival at 2 and 7 days was 90.1% and 45.5%, respectively. Conclusions: In this cohort, a mortality rate of 68.7% was observed in the ICU, with a survival rate of 45.5% at 7 days and less than 10% at 18 days. No associations were found between survival and any of the variables of interest.Introducción: La COVID-19, causada por el Coronavirus 2 del Síndrome Respiratorio Agudo Severo (SARS-CoV-2), ha alcanzado proporciones pandémicas a nivel mundial, prolongándose en el tiempo. En este contexto, el presente estudio tiene como objetivo analizar los factores asociados a la mortalidad en pacientes hospitalizados por COVID-19 en un hospital de tercer nivel de la región Lambayeque. Material y método: Se realizó un estudio de cohorte retrospectivo de los pacientes con diagnóstico de COVID-19, hospitalizados en el Hospital Nacional Almanzor Aguinaga Asenjo (HNAAA) durante los meses de marzo a septiembre del 2020.  Resultados: Se examinaron cuarenta pacientes que ingresaron en la Unidad de Cuidados Intensivos (UCI), de los cuales veintidós necesitaron ventilación mecánica (VM). La mortalidad general en la UCI fue del 68.7%, mientras que la mortalidad entre los pacientes que necesitaron ventilación mecánica fue del 91.6%. Se encontró una asociación estadística entre el fallecimiento y los signos vitales al ingreso en la UCI, así como con el tiempo de espera para el ingreso. La probabilidad de supervivencia a 2 y 7 días fue del 90.1% y del 45.5%, respectivamente. Conclusiones: En esta cohorte, se observó una tasa de mortalidad del 68.7% en UCI, con una tasa de supervivencia del 45.5% a los 7 días y menos del 10% a los 18 días. No se encontró asociaciones entre la supervivencia y ninguna de las variables de interés

COVID-19 and dengue coinfection in Latin America: A systematic review

"Introduction: Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread globally, becoming a long-lasting pandemic. Dengue is the most common arboviral disease in tropical and subtropical regions worldwide. COVID-19 and dengue coinfections have been reported, associated with worse outcomes with significant morbidity and mortality. Therefore, this study aims to determine the epidemiological situation of COVID-19 and dengue coinfection in Latin America. Methods: A systematic literature review was performed using PubMed, Scopus, Embase, Web of Science, LILACS, and BVS databases from January 1, 2020, to September 4, 2021. The key search terms used were ""dengue"" and ""COVID-19"". Results: Nineteen published articles were included. The studies were case reports with a detailed description of the coinfection’s clinical, laboratory, diagnostic, and treatment features. Conclusion: Coinfection with SARS-CoV-2 and dengue virus is associated with worse outcomes with significant morbidity and mortality. The similar clinical and laboratory features of each infection are a challenge in accurately diagnosing and treating cases. Establishing an early diagnosis could be the answer to reducing the estimated significant burden of these conditions.

Group A streptococcal infection in the United Kingdom: an emerging threat

Within group A Streptococcus (GAS), only Streptococcus pyogenes exhibits clinical significance. GAS is typed serologically based on unique surface proteins and critical virulence factors, such as a hyaluronic acid capsule that shields GAS from phagocytosis. The burden of GAS was estimated in the last five years as 14,000 to 25,000 cases of the invasive group A streptococcal disease in the USA with an estimated death from 1,500 to 2,300 cases per year. Early in the summer of 2022 in England, there was more scarlet fever than was anticipated. Early in the current season, the number of notifications rose to unusual heights. The analysis of invasive GAS (iGAS) isolate typing data shows that this season has seen a wide variety of encoding mature M protein (emm) gene sequence types found. Therefore, public health authorities should think about initiatives to increase clinicians’ and the general public’s awareness of GAS infections and to promote their quick diagnosis, molecular testing and antibiotic susceptibility testing, and standard treatment

Predictive models of intensive care unit admission in patients with covid-19: systematic review

Introducción:Es fundamental identificar las características epidemiológicas y clínicas de los pacientes infectados con COVID-19, asociadas a una progresión de la enfermedad que conlleva al ingreso a UCI. El objetivo fue revisar sistemáticamente los modelos o scores de predicción de ingreso a la unidad de cuidados intensivos(UCI)disponibles a la fecha para pacientes con COVID-19.Métodos:El estudio es una revisión sistemática. Se hicieronbúsquedas en PubMed, Scopus, Web of Science, Ovid-Medline, y Embasehasta el 13 de Julio del 2022. Se incluyeron estudios que hayan desarrollado y validado un modelo o sistema de puntuación para predecir el ingreso a la UCI en pacientes con COVID-19.El desenlace primario fue el ingreso a la UCI.La evaluación del riesgo de sesgo se realizó utilizando la herramienta PROBASTque se basa en cuatro dominios: participantes, predictores, desenlace y análisis.Resultados:Se incluyerondosestudiospara la extracción de datos y la evaluación crítica.Se obtuvo como desenlaces primarios los modelos predictivos de ingreso a la UCI y su rendimiento. Los predictores comunes para ambos modelos se asociaron con el compromiso pulmonar (frecuencia respiratoria o ventilación pulmonar) y la inflamación sistémica (proteína C reactiva).Conclusiones:Es factible determinar variables predictoras de ingreso a UCI en los pacientes hospitalizados por COVID-19. Sin embargo; los estudios no determinan un score claramente definido y presentan un alto riesgo de sesgo, porlo que no es factible recomendar la aplicación de alguno de estos modelos en la práctica clínica