Comorbilidades asociadas a la mortalidad por COVID-19 en adultos en Lima, Perú: un estudio de cohorte retrospectiva

Objetivos. Evaluar las comorbilidades asociadas a la mortalidad en pacientes adultos hospitalizados por COVID-19 19 de diferentes grupos de edad en hospitales de Lima y Callao. Materiales y métodos. En este estudio de cohorte retrospectiva analizamos datos de pacientes adultos hospitalizados por COVID-19 notificados al Sistema Nacional de Vigilancia Epidemiológica del Ministerio de Salud de Perú de marzo a octubre del 2020. Se estimaron riesgos relativos con intervalos de confianza al 95% mediante modelos de regresión de Poisson con varianza robusta para evaluar las comorbilidades asociadas a la mortalidad por grupos de edad: jóvenes (18-29 años), adultos (30-59 años) y mayores (≥60 años). Resultados. Se incluyeron 2366 jóvenes, 23781 adultos y 25356 adultos mayores en el análisis. Los adultos mayores presentaron la mortalidad más alta (63,7%) en comparación con adultos (27,1%) y jóvenes (8,5%). Independientemente del grupo de edad, la presencia de enfermedad neurológica, enfermedad renal, enfermedad hepática y cáncer se asoció a un mayor riesgo de mortalidad. Adicionalmente, la enfermedad cardiovascular es también un factor de riesgo en los jóvenes; la obesidad, la diabetes, la enfermedad cardiovascular, la enfermedad pulmonar crónica y la inmunodeficiencia en los adultos; y la obesidad y la enfermedad pulmonar crónica en los mayores. Conclusiones: Independientemente de los grupos de edad, los individuos con enfermedad neurológica crónica, enfermedad renal, enfermedad hepática y cáncer tendrían un alto riesgo de morir por la COVID-19

Violent Governance, Identity and the Production of Legitimacy: Autodefensas in Latin America

This article examines the intersections of violence, governance, identity and legitimacy in relation to autodefensas (self-defence groups) in Latin America, focusing on Mexico and Colombia. By shifting focus from the question of where legitimacy lies to how it is produced and contested by a range of groups, we challenge the often presumed link between the state and legitimacy. We develop the idea of a field of negotiation and contestation, firstly, to discuss and critique the concept of state failure as not merely a Western hegemonic claim but also a strategic means of producing legitimacy by autodefensas. Secondly, we employ and enrich the notion of violent pluralism to discuss the pervasiveness of violence and the role of neoliberalism, and to address the question of non-violent practices of governance. We argue that the idea of a field of contestation and negotiation helps to understand the complexity of relationships that encompass the production of legitimacy and identity through (non)violent governance, whereby lines between (non)state, (non)violence, and (il)legitimacy blur and transform. Yet, we do not simply dismiss (binary) distinctions as these continue to be employed by groups in their efforts to produce, justify, challenge, contest and negotiate their own and others’ legitimacy and identity

Extreme work environments and career commitment of nurses during COVID-19:empirical evidence from Egypt and Peru

Abstract Purpose: This paper aim to analyse the motives behind the commitment of nurses to their profession despite their intense job duties during the COVID-19 pandemic. Methodology: The empirical sample comprises of 35 semi-structured interviews with public sector hospital nurses in under-researched contexts of Egypt and Peru. Findings: Three types of motives were found to play a critical role in nurses’ commitment to their profession despite the difficulties associated with extreme work conditions. These factors include cultural (religious values, governmental coercion), contextual (limited education, organisational support) and personal (good nurse identity, submissive nature) dimensions. Originality/ value: This paper is one of the pioneering works to link existing literature streams on career commitment, extreme jobs, extreme context, and management under disruptions (particularly Covid-19) by analysing these aspects in the under-researched Peruvian and Egyptian contexts

The taxonomy of the model filamentous fungus Podospora anserina

International audienceThe filamentous fungus Podospora anserina has been used as a model organism for more than 100 years and has proved to be an invaluable resource in numerous areas of research. Throughout this period, P. anserina has been embroiled in a number of taxonomic controversies regarding the proper name under which it should be called. The most recent taxonomic treatment proposed to change the name of this important species to Triangularia anserina. The results of past name changes of this species indicate that the broader research community is unlikely to accept this change, which will lead to nomenclatural instability and confusion in literature. Here, we review the phylogeny of the species closely related to P. anserina and provide evidence that currently available marker information is insufficient to resolve the relationships amongst many of the lineages. We argue that it is not only premature to propose a new name for P. anserina based on current data, but also that every effort should be made to retain P. anserin

The taxonomy of the model filamentous fungus Podospora anserina

The filamentous fungus Podospora anserina has been used as a model organism for more than 100 years and has proved to be an invaluable resource in numerous areas of research. Throughout this period, P. anserina has been embroiled in a number of taxonomic controversies regarding the proper name under which it should be called. The most recent taxonomic treatment proposed to change the name of this important species to Triangularia anserina. The results of past name changes of this species indicate that the broader research community is unlikely to accept this change, which will lead to nomenclatural instability and confusion in literature. Here, we review the phylogeny of the species closely related to P. anserina and provide evidence that currently available marker information is insufficient to resolve the relationships amongst many of the lineages. We argue that it is not only premature to propose a new name for P. anserina based on current data, but also that every effort should be made to retain P. anserina as the current name to ensure stability and to minimise confusion in scientific literature. Therefore, we synonymise Triangularia with Podospora and suggest that either the type species of Podospora be moved to P. anserina from P. fimiseda or that all species within the Podosporaceae be placed in the genus Podospora

The taxonomy of the model filamentous fungus Podospora anserina

The filamentous fungus Podospora anserina has been used as a model organism for more than 100 years and has proved to be an invaluable resource in numerous areas of research. Throughout this period, P. anserina has been embroiled in a number of taxonomic controversies regarding the proper name under which it should be called. The most recent taxonomic treatment proposed to change the name of this important species to Triangularia anserina. The results of past name changes of this species indicate that the broader research community is unlikely to accept this change, which will lead to nomenclatural instability and confusion in literature. Here, we review the phylogeny of the species closely related to P. anserina and provide evidence that currently available marker information is insufficient to resolve the relationships amongst many of the lineages. We argue that it is not only premature to propose a new name for P. anserina based on current data, but also that every effort should be made to retain P. anserina as the current name to ensure stability and to minimise confusion in scientific literature. Therefore, we synonymise Triangularia with Podospora and suggest that either the type species of Podospora be moved to P. anserina from P. fimiseda or that all species within the Podosporaceae be placed in the genus Podospora

Surgical site infection after gastrointestinal surgery in children : an international, multicentre, prospective cohort study

Introduction Surgical site infection (SSI) is one of the most common healthcare-associated infections (HAIs). However, there is a lack of data available about SSI in children worldwide, especially from low-income and middle-income countries. This study aimed to estimate the incidence of SSI in children and associations between SSI and morbidity across human development settings. Methods A multicentre, international, prospective, validated cohort study of children aged under 16 years undergoing clean-contaminated, contaminated or dirty gastrointestinal surgery. Any hospital in the world providing paediatric surgery was eligible to contribute data between January and July 2016. The primary outcome was the incidence of SSI by 30 days. Relationships between explanatory variables and SSI were examined using multilevel logistic regression. Countries were stratified into high development, middle development and low development groups using the United Nations Human Development Index (HDI). Results Of 1159 children across 181 hospitals in 51 countries, 523 (45 center dot 1%) children were from high HDI, 397 (34 center dot 2%) from middle HDI and 239 (20 center dot 6%) from low HDI countries. The 30-day SSI rate was 6.3% (33/523) in high HDI, 12 center dot 8% (51/397) in middle HDI and 24 center dot 7% (59/239) in low HDI countries. SSI was associated with higher incidence of 30-day mortality, intervention, organ-space infection and other HAIs, with the highest rates seen in low HDI countries. Median length of stay in patients who had an SSI was longer (7.0 days), compared with 3.0 days in patients who did not have an SSI. Use of laparoscopy was associated with significantly lower SSI rates, even after accounting for HDI. Conclusion The odds of SSI in children is nearly four times greater in low HDI compared with high HDI countries. Policies to reduce SSI should be prioritised as part of the wider global agenda.Peer reviewe

International eDelphi Study to Reach Consensus on the Methotrexate Dosing Regimen in Patients with Psoriasis

Importance: A clear dosing regimen for methotrexate in psoriasis is lacking, and this might lead to a suboptimal treatment. Because methotrexate is affordable and globally available, a uniform dosing regimen could potentially optimize the treatment of patients with psoriasis worldwide. Objective: To reach international consensus among psoriasis experts on a uniform dosing regimen for treatment with methotrexate in adult and pediatric patients with psoriasis and identify potential future research topics. Design, Setting, and Participants: Between September 2020 and March 2021, a survey study with a modified eDelphi procedure that was developed and distributed by the Amsterdam University Medical Center and completed by 180 participants worldwide (55 [30.6%] resided in non-Western countries) was conducted in 3 rounds. The proposals on which no consensus was reached were discussed in a conference meeting (June 2021). Participants voted on 21 proposals with a 9-point scale (1-3 disagree, 4-6 neither agree nor disagree, 7-9 agree) and were recruited through the Skin Inflammation and Psoriasis International Network and European Academy of Dermatology and Venereology in June 2020. Apart from being a dermatologist/dermatology resident, there were no specific criteria for participation in the survey. The participants worked mainly at a university hospital (97 [53.9%]) and were experienced in treating patients with psoriasis with methotrexate (163 [91.6%] had more than 10 years of experience). Main Outcomes and Measures: In a survey with eDelphi procedure, we tried to reach consensus on 21 proposals. Consensus was defined as less than 15% voting disagree (1-3). For the consensus meeting, consensus was defined as less than 30% voting disagree. Results: Of 251 participants, 180 (71.7%) completed all 3 survey rounds, and 58 participants (23.1%) joined the conference meeting. Consensus was achieved on 11 proposals in round 1, 3 proposals in round 2, and 2 proposals in round 3. In the consensus meeting, consensus was achieved on 4 proposals. More research is needed, especially for the proposals on folic acid and the dosing of methotrexate for treating subpopulations such as children and vulnerable patients. Conclusions and Relevance: In this eDelphi consensus study, consensus was reached on 20 of 21 proposals involving methotrexate dosing in patients with psoriasis. This consensus may potentially be used to harmonize the treatment with methotrexate in patients with psoriasis.