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

The ventricular ectopic QRS interval (VEQSI): A potential marker for ventricular arrhythmia in ischaemic heart disease

Objectives The purpose of this study was to determine the potential value of a novel marker for the severity of structural heart disease and the risk of arrhythmia. Background The ventricular ectopic QRS interval (VEQSI) has been shown to identify structural heart disease and predict mortality in an unselected population. In ischemic heart disease (IHD), risk stratification for sudden death is imperfect. We hypothesized that VEQSI would identify patients with prior myocardial infarction (MI) compared with healthy subjects and distinguish IHD patients who have suffered life-threatening events from those without prior significant ventricular arrhythmia. Methods The 12-lead Holter recordings from 189 patients with previous MI were analyzed: 38 with prior ventricular tachycardia/ventricular fibrillation (MI-VT/VF) (66 ± 9 years; 92% male); 151 without prior significant ventricular arrhythmia (MI-no VT/VF) (64 ± 11 years; 74% male). These were compared with 60 healthy controls (62 ± 7 years; 70% male). All ventricular ectopic beats were reviewed and maximal VEQSI duration (VESQI max) was recorded as the duration of the longest ventricular ectopic beat. Results VEQSI max was longer in post-MI patients compared with normal controls (185 ± 26 ms vs. 164 ± 16 ms; p 198 ms had 86% sensitivity, 85% specificity, 62% positive predictive value, and 96% negative predictive value for identifying patients with prior life-threatening events (odds ratio: 37.4; 95% confidence interval: 13.0 to 107.5). Conclusions VEQSI max >198 ms distinguishes post-MI patients with prior life-threatening events from those without prior significant ventricular arrhythmia. This may be a useful additional index for risk stratification in IHD

Mental Health in university students in social isolation during the COVID-19 Pandemic. Arequipa, Peru.

Introducción: La Pandemia COVID-19, ha tenido impactos negativos en la salud física y mental de las personas, así como las medidas adoptadas por los gobiernos, para prevenir el contagio masivo de la población como el confinamiento, el aislamiento social, el trabajo y educación virtual. Dentro de los afectados por estos cambios, se encontrarían los estudiantes universitarios del área de la salud, que además de estudiar en estas condiciones de pandemia, no han podido hacer sus prácticas de los servicios de salud. Esta situación de exposición al aislamiento, podría afectar la salud mental de los jóvenes estudiantes universitarios.  Objetivo: determinar los niveles de depresión, ansiedad y estrés en estudiantes universitarios y su relación con variables sociodemográficas y las características del aislamiento social durante la Pandemia COVID-19.. Métodos:  Se realizó un estudio descriptivo, observacional, de corte transversal y cuantitativo, con una muestra de 818 estudiantes universitarios de facultades de ciencias de la salud, mediante el cuestionario autoadministrado DASS-21. Resultados:  Los principales hallazgos fueron: una mayor prevalencia en niveles altos (severos y extremadamente severos) en la ansiedad, alcanzado casi a 4 de cada 10 de los evaluados; por otro lado, en depresión y el estrés, 2 de cada 10 de los evaluados, se encontraron en los niveles mencionados. En relación con las variables sociodemográficas, las relacionadas con el COVID-19 y aislamiento social, se hallaron diferencias estadísticamente significativas con el género (mujeres > varones), el haber tenido COVID-19 (Si > No) y vivir con familiares como antes de la pandemia (Si > No) obtuvieron en promedio mayores puntajes en depresión, ansiedad y estrés. Conclusión: Los estudiantes que presentaron mayor depresión, ansiedad y estrés con una diferencia significativa fueron de género femenino, con antecedentes de haber tenido Covid-19, menor contacto con famiiares y haber cumplido con aislamiento social totalAbstractIntroduction: The COVID-19 Pandemic has had negative impacts on the physical and mental health of people, as well as the measures adopted by governments to prevent the massive contagion of the population, such as confinement, social isolation, virtual work, and virtual education. Among those affected by these changes would be university students in the health area who, in addition to studying in these pandemic conditions, have been unable to do their health service practices. This situation of exposure to isolation could affect the mental health of young university students. Objective: To determine the levels of depression, anxiety, and stress in university students, their relationship with sociodemographic variables, and the characteristics of social isolation during the COVID-19 Pandemic. Methods: A descriptive, observational, cross-sectional, and quantitative study was carried out with a sample of 818 university students from health sciences faculties using the DASS-21 self-administered questionnaire. Results: The main findings were a higher prevalence of high levels (severe and highly severe) in anxiety, reaching almost 4 out of 10 of those evaluated; On the other hand, in depression and stress, 2 out of 10 of those evaluated were found at the mentioned levels. Concerning the sociodemographic variables, those related to COVID-19 and social isolation, statistically significant differences were found with gender (women > men), having had COVID-19 (Yes > No), and living with relatives as before. On average, the pandemic (Yes > No) obtained higher scores in depression, anxiety, and stress. Conclusion: The students who presented greater depression, anxiety, and stress with a significant difference were female, with a history of having had Covid-19, less contact with family members, and having complied with total social isolation &nbsp

Anticoagulant selection in relation to the SAMe-TT2R2 score in patients with atrial fibrillation. the GLORIA-AF registry

Aim: The SAMe-TT2R2 score helps identify patients with atrial fibrillation (AF) likely to have poor anticoagulation control during anticoagulation with vitamin K antagonists (VKA) and those with scores >2 might be better managed with a target-specific oral anticoagulant (NOAC). We hypothesized that in clinical practice, VKAs may be prescribed less frequently to patients with AF and SAMe-TT2R2 scores >2 than to patients with lower scores. Methods and results: We analyzed the Phase III dataset of the Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation (GLORIA-AF), a large, global, prospective global registry of patients with newly diagnosed AF and ≥1 stroke risk factor. We compared baseline clinical characteristics and antithrombotic prescriptions to determine the probability of the VKA prescription among anticoagulated patients with the baseline SAMe-TT2R2 score >2 and ≤ 2. Among 17,465 anticoagulated patients with AF, 4,828 (27.6%) patients were prescribed VKA and 12,637 (72.4%) patients an NOAC: 11,884 (68.0%) patients had SAMe-TT2R2 scores 0-2 and 5,581 (32.0%) patients had scores >2. The proportion of patients prescribed VKA was 28.0% among patients with SAMe-TT2R2 scores >2 and 27.5% in those with scores ≤2. Conclusions: The lack of a clear association between the SAMe-TT2R2 score and anticoagulant selection may be attributed to the relative efficacy and safety profiles between NOACs and VKAs as well as to the absence of trial evidence that an SAMe-TT2R2-guided strategy for the selection of the type of anticoagulation in NVAF patients has an impact on clinical outcomes of efficacy and safety. The latter hypothesis is currently being tested in a randomized controlled trial. Clinical trial registration: URL: https://www.clinicaltrials.gov//Unique identifier: NCT01937377, NCT01468701, and NCT01671007

The Changing Landscape for Stroke\ua0Prevention in AF: Findings From the GLORIA-AF Registry Phase 2

Background GLORIA-AF (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients with Atrial Fibrillation) is a prospective, global registry program describing antithrombotic treatment patterns in patients with newly diagnosed nonvalvular atrial fibrillation at risk of stroke. Phase 2 began when dabigatran, the first non\u2013vitamin K antagonist oral anticoagulant (NOAC), became available. Objectives This study sought to describe phase 2 baseline data and compare these with the pre-NOAC era collected during phase 1. Methods During phase 2, 15,641 consenting patients were enrolled (November 2011 to December 2014); 15,092 were eligible. This pre-specified cross-sectional analysis describes eligible patients\u2019 baseline characteristics. Atrial fibrillation disease characteristics, medical outcomes, and concomitant diseases and medications were collected. Data were analyzed using descriptive statistics. Results Of the total patients, 45.5% were female; median age was 71 (interquartile range: 64, 78) years. Patients were from Europe (47.1%), North America (22.5%), Asia (20.3%), Latin America (6.0%), and the Middle East/Africa (4.0%). Most had high stroke risk (CHA2DS2-VASc [Congestive heart failure, Hypertension, Age  6575 years, Diabetes mellitus, previous Stroke, Vascular disease, Age 65 to 74 years, Sex category] score  652; 86.1%); 13.9% had moderate risk (CHA2DS2-VASc = 1). Overall, 79.9% received oral anticoagulants, of whom 47.6% received NOAC and 32.3% vitamin K antagonists (VKA); 12.1% received antiplatelet agents; 7.8% received no antithrombotic treatment. For comparison, the proportion of phase 1 patients (of N = 1,063 all eligible) prescribed VKA was 32.8%, acetylsalicylic acid 41.7%, and no therapy 20.2%. In Europe in phase 2, treatment with NOAC was more common than VKA (52.3% and 37.8%, respectively); 6.0% of patients received antiplatelet treatment; and 3.8% received no antithrombotic treatment. In North America, 52.1%, 26.2%, and 14.0% of patients received NOAC, VKA, and antiplatelet drugs, respectively; 7.5% received no antithrombotic treatment. NOAC use was less common in Asia (27.7%), where 27.5% of patients received VKA, 25.0% antiplatelet drugs, and 19.8% no antithrombotic treatment. Conclusions The baseline data from GLORIA-AF phase 2 demonstrate that in newly diagnosed nonvalvular atrial fibrillation patients, NOAC have been highly adopted into practice, becoming more frequently prescribed than VKA in Europe and North America. Worldwide, however, a large proportion of patients remain undertreated, particularly in Asia and North America. (Global Registry on Long-Term Oral Antithrombotic Treatment in Patients With Atrial Fibrillation [GLORIA-AF]; NCT01468701

Molecular mechanisms of cell death: recommendations of the Nomenclature Committee on Cell Death 2018.

Over the past decade, the Nomenclature Committee on Cell Death (NCCD) has formulated guidelines for the definition and interpretation of cell death from morphological, biochemical, and functional perspectives. Since the field continues to expand and novel mechanisms that orchestrate multiple cell death pathways are unveiled, we propose an updated classification of cell death subroutines focusing on mechanistic and essential (as opposed to correlative and dispensable) aspects of the process. As we provide molecularly oriented definitions of terms including intrinsic apoptosis, extrinsic apoptosis, mitochondrial permeability transition (MPT)-driven necrosis, necroptosis, ferroptosis, pyroptosis, parthanatos, entotic cell death, NETotic cell death, lysosome-dependent cell death, autophagy-dependent cell death, immunogenic cell death, cellular senescence, and mitotic catastrophe, we discuss the utility of neologisms that refer to highly specialized instances of these processes. The mission of the NCCD is to provide a widely accepted nomenclature on cell death in support of the continued development of the field

Adecuación cultural y capacitación acerca del proceso de consentimiento informado en proyecto sobre nutrición escolar en un pueblo indígena Aymara de Perú

Background: Research must respect ethical norms and informed consent (IC), with appropriate cultural adaptation and verification of its understanding in indigenous communities of the Andean and Amazonian regions, including social and medical research. Objective: Determine to what extent IC is understood in an Aymara community in Peru, specifically as concerns a school nutrition project. Methodology: A prospective, quasi-experimental field study of an educational intervention was conducted in Puno during 2015. The objectives and procedures of the school nutrition project in question were explained to the local Aymara leaders, and a questionnaire was prepared on knowledge and practices regarding healthy lunch boxes for Aymara children. An educational nutrition program and two IC formats (simple and culturally appropriate) were drawn up. The documentation was evaluated by a research ethics committee. Results: Seventy (70) Aymara villagers participated in the research project. The extent to which they understood the IC was modified to a statistically significant degree subsequent to the educational intervention and adaption for cultural appropriateness.Antecedentes: é importante que as pesquisas respeitem normas éticas e a tomada do consentimento informado (CI) com a devida adequação cultural e verificando sua compreensão em comunidades indígenas das regiões andina e amazônica, incluídas hoje em pesquisas sociais e médicas. Objetivo: determinar o grau de compreensão do CI numa comunidade aymara do Peru com um projeto de nutrição escolar. Metodologia: realizou-se um estudo de campo quase experimental, prospectivo, de intervenção educativa em Puno, em 2015. Explicou-se aos líderes aymaras os objetivos e os procedimentos do estudo de nutrição escolar e CI. Fizeram-se um questionário de conhecimentos e práticas de lancheiras saudáveis para crianças aymaras; um programa educativo de nutrição e escolar e dois formulários de CI (simples e com adequação cultural). A documentação foi avaliada por um comitê de ética da pesquisa. Resultados: 70 moradores aymaras participaram do projeto de pesquisa. O grau de compreensão do CI se modificou com significância estatística após a intervenção educativa e a adequação cultural.Antecedentes: es importante que las investigaciones respeten normas éticas y la toma del consentimiento informado (CI) con la debida adecuación cultural y verificando su comprensión en comunidades indígenas de las regiones Andina y Amazónica, incluidas hoy en investigaciones sociales y médicas. Objetivo: determinar el grado de comprensión del CI en una comunidad aymara del Perú con un proyecto de nutrición escolar. Metodología: se realizó un estudio de campo cuasi experimental, prospectivo, de intervención educativa en Puno, en 2015. Se explicó a los líderes aymaras los objetivos y procedimientos del estudio de nutrición escolar y CI. Se confeccionó un cuestionario de conocimientos y prácticas de loncheras saludables para niños aymaras; un programa educativo de nutrición escolar y dos formatos de CI (simple y con adecuación cultural). La documentación fue evaluada por un comité de ética de la investigación. Resultados: 70 pobladores aymaras participaron del proyecto de investigación. El grado de comprensión del CI se modificó con significancia estadística luego de la intervención educativa y la adecuación cultural

A NOVEL APPROACH TO THE PERCEPTION OF PRECURSORS DIRECTED TO THE AUTOMATIC ORGANIC SYNTHESIS DESIGN SYSTEM AIPHOS.

豊橋技術科学大