Enfermedad de Eales secundario a tuberculosis: a propósito de un caso

La enfermedad de Eales es una perivasculitis retiniana caracterizada por tres fases que incluyen a la inflamación, isquemia y neovascularización de la retina. Se reporta el caso de un paciente varón de 29 años con pérdida progresiva de la visión de un año de evolución sin respuesta a tratamiento médico ni quirúrgico, diagnosticado con enfermedad de Eales de causa tuberculosa. La etiología de la enfermedad de Eales es multifactorial, por ello el tratamiento continúa siendo controversial. Sin embargo, se postula un tipo de hipersensibilidad a la proteína tuberculosa, la cual estaría relacionada con la enfermedad. Después de iniciar el tratamiento con antituberculosos, mejoró la agudeza visual del paciente y desaparecieron las hemorragias; es decir, se obtuvo una respuesta favorable

Gangrena de Fournier en paciente obeso con COVID-19: reporte de caso

La Gangrena de Fournier (GF) es una fascitis necrotizante que afecta los planos superficiales. Se presenta frecuentemente en hombres entre 50 y 79 años con una elevada tasa de mortalidad, la cual aumenta con la presencia de factores de riesgo destacándose entre ellos la diabetes y obesidad. Se reporta el caso de un paciente obeso diagnosticado con COVID-19 antes del ingreso y tratado con corticoides, que acude por aparente celulitis escrotal que evoluciona a GF, la cual fue diagnosticada 2 días luego de la hospitalización. Se le realiza intervención quirúrgica inmediata, previa cobertura antibiótica. La COVID-19 no tuvo relevancia clínica en la evolución y pronóstico de la GF; sin embargo, fueron las terapias desmesuradas las que influyeron negativamente. A pesar de ello, el paciente evolucionó favorablemente hasta su recuperación total. Palabras clave: Gangrena de Fournier, obesidad, COVID-19 (MeSH) DOI: http://dx.doi.org/10.17268/rmt.2020.v16i01.1

Modificaciones de la conducta alimentaria, actividad física y salud mental por la cuarentena COVID-19 en adultos jóvenes

In Peru, one of the first interventions to flattened the epidemiologic curve of the pandemic was quarantine that changed eating behavior, physical activity and mental health of the population. Objective: to determine modifications in eating behavior, physical activity and mental health in young adults before and after the quarantine. Methods: cohort study involving 384 adults from 18 to 24 years of age that were subjected to a virtual interview and application of an international questionnaire to evaluate changings in eating behavior, physical activity and mental health contrasted by Chi square. Results: an increase in the distribution of daily foods [breakfast (p<0.001), morning snack (p<0.05), lunch (p<0.001), afternoon snack (p<0.001), dinner (p<0.05)] and an increase in ingestion of fruits (p=0.005) and reduction in the ingestion of fast food (p<0.05) and candies (p=0.03). Physical activity decreases specially in males vs females (28.4% vs. 25.3%) and there was a reduction in the total number of sleep hours, mental health was severely affected. Conclusions: quarantine induced variations in eating behavior, reduction in physical activity and increase in mental health disorders. These modifications put the population at risk for weight gain or obesity and eventually to non-transmissible diseases.En Perú, una de las primeras medidas preventivas para allanar la curva epidemiológica de la pandemia COVID-19 fue la cuarentena, que cambió de forma importante la conducta alimentaria, la actividad física y la salud mental. Objetivo: Determinar las modificaciones de la conducta alimentaria, actividad física y salud mental antes y durante la cuarentena por la pandemia COVID-19 en adultos jóvenes. Material y métodos: Estudio observacional, descriptivo, longitudinal en 384 adultos entre 18 y 24 años, mediante una encuesta virtual que incluyó: Cuestionario de frecuencia de consumo de alimentos, Cuestionario Internacional de Actividad física y Cuestionario de cambios en la salud mental, analizados mediante ji – cuadrado. Resultados: Durante la cuarentena se encontró un incremento en la distribución de frecuencia de comidas diarias [desayuno (p < 0,001), media mañana (p < 0,05), almuerzo (p< 0,001), merienda (p<0,001), cena (p < 0,05)] y de las preferencias alimentarias, con aumento en el consumo de frutas (p = 0,005) y una disminución de comidas rápidas (p < 0,05) y golosinas (p = 0,03). El nivel de actividad física bajo fue más frecuente (Varones: 28,4%; Mujeres: 25,3%) y hubo una disminución en las horas de sueño, por otro lado, la salud mental se vio severamente afectada durante la cuarentena. Conclusiones: Los resultados indican que la cuarentena ha producido variaciones en la conducta alimentaria, una disminución de la actividad física y un aumento de problemas de salud mental. Estas modificaciones representan un riesgo de sobrepeso u obesidad, incluso, desarrollo de enfermedades no transmisibles

Search strategy.

ObjectiveThe objective of this systematic review and meta-analysis was to assess the prevalence of hypertension in populations living at altitude in Latin America and the Caribbean.MethodsWe conducted a systematic search from January 1, 2000 to January 10, 2023 in Web of Science (WoS)/Core Collection, WoS/Medline, WoS/Scielo, Scopus, PubMed and Embase databases. We included studies that assessed the prevalence of hypertension in altitude populations (>1500 m.a.s.l.) and these were meta-analyzed using a random-effects model. To assess the sources of heterogeneity, we performed subgroup and meta-regression analyses.ResultsThirty cross-sectional studies (117 406 participants) met the inclusion criteria. Studies used different cut-off points. The prevalence of hypertension in the studies that considered the cut-off point of ≥ 140/90 mmHg in the general population was 19.1%, ≥ 130/85 mmHg was 13.1%, and ≥ 130/80 mmHg was 43.4%. There was a tendency for the prevalence of hypertension to be higher in men. In meta-regression analyses, no association was found between altitude, mean age, year of publication, risk of bias and prevalence of hypertension.ConclusionThe prevalence of hypertension in the altitude population of Latin America and the Caribbean is lower than that reported in populations living at sea level and lower than other altitude populations such as Tibetans.PROSPEROCRD42021275229.</div

Excluded studies and reasons.

ObjectiveThe objective of this systematic review and meta-analysis was to assess the prevalence of hypertension in populations living at altitude in Latin America and the Caribbean.MethodsWe conducted a systematic search from January 1, 2000 to January 10, 2023 in Web of Science (WoS)/Core Collection, WoS/Medline, WoS/Scielo, Scopus, PubMed and Embase databases. We included studies that assessed the prevalence of hypertension in altitude populations (>1500 m.a.s.l.) and these were meta-analyzed using a random-effects model. To assess the sources of heterogeneity, we performed subgroup and meta-regression analyses.ResultsThirty cross-sectional studies (117 406 participants) met the inclusion criteria. Studies used different cut-off points. The prevalence of hypertension in the studies that considered the cut-off point of ≥ 140/90 mmHg in the general population was 19.1%, ≥ 130/85 mmHg was 13.1%, and ≥ 130/80 mmHg was 43.4%. There was a tendency for the prevalence of hypertension to be higher in men. In meta-regression analyses, no association was found between altitude, mean age, year of publication, risk of bias and prevalence of hypertension.ConclusionThe prevalence of hypertension in the altitude population of Latin America and the Caribbean is lower than that reported in populations living at sea level and lower than other altitude populations such as Tibetans.PROSPEROCRD42021275229.</div

Risk of bias of included studies using the Joanna Briggs Institute Critical Appraisal Tool for prevalence studies.

Risk of bias of included studies using the Joanna Briggs Institute Critical Appraisal Tool for prevalence studies.</p

Meta-regression analyses.

ObjectiveThe objective of this systematic review and meta-analysis was to assess the prevalence of hypertension in populations living at altitude in Latin America and the Caribbean.MethodsWe conducted a systematic search from January 1, 2000 to January 10, 2023 in Web of Science (WoS)/Core Collection, WoS/Medline, WoS/Scielo, Scopus, PubMed and Embase databases. We included studies that assessed the prevalence of hypertension in altitude populations (>1500 m.a.s.l.) and these were meta-analyzed using a random-effects model. To assess the sources of heterogeneity, we performed subgroup and meta-regression analyses.ResultsThirty cross-sectional studies (117 406 participants) met the inclusion criteria. Studies used different cut-off points. The prevalence of hypertension in the studies that considered the cut-off point of ≥ 140/90 mmHg in the general population was 19.1%, ≥ 130/85 mmHg was 13.1%, and ≥ 130/80 mmHg was 43.4%. There was a tendency for the prevalence of hypertension to be higher in men. In meta-regression analyses, no association was found between altitude, mean age, year of publication, risk of bias and prevalence of hypertension.ConclusionThe prevalence of hypertension in the altitude population of Latin America and the Caribbean is lower than that reported in populations living at sea level and lower than other altitude populations such as Tibetans.PROSPEROCRD42021275229.</div

Overall and subgroups prevalence of hypertension in the general population of the altitude.

Overall and subgroups prevalence of hypertension in the general population of the altitude.</p

Characteristics of included studies assessing the prevalence of hypertension in the altitude of Latin America and the Caribbean (n = 30).

Characteristics of included studies assessing the prevalence of hypertension in the altitude of Latin America and the Caribbean (n = 30).</p

PRISMA checklist 2020.

ObjectiveThe objective of this systematic review and meta-analysis was to assess the prevalence of hypertension in populations living at altitude in Latin America and the Caribbean.MethodsWe conducted a systematic search from January 1, 2000 to January 10, 2023 in Web of Science (WoS)/Core Collection, WoS/Medline, WoS/Scielo, Scopus, PubMed and Embase databases. We included studies that assessed the prevalence of hypertension in altitude populations (>1500 m.a.s.l.) and these were meta-analyzed using a random-effects model. To assess the sources of heterogeneity, we performed subgroup and meta-regression analyses.ResultsThirty cross-sectional studies (117 406 participants) met the inclusion criteria. Studies used different cut-off points. The prevalence of hypertension in the studies that considered the cut-off point of ≥ 140/90 mmHg in the general population was 19.1%, ≥ 130/85 mmHg was 13.1%, and ≥ 130/80 mmHg was 43.4%. There was a tendency for the prevalence of hypertension to be higher in men. In meta-regression analyses, no association was found between altitude, mean age, year of publication, risk of bias and prevalence of hypertension.ConclusionThe prevalence of hypertension in the altitude population of Latin America and the Caribbean is lower than that reported in populations living at sea level and lower than other altitude populations such as Tibetans.PROSPEROCRD42021275229.</div