The value of the world conferences on research integrity : perspectives from Peru

“The World Conferences on Research Integrity (WCRIs), six to date, were initiated at a time when researchers in various countries were at quite different stages in their thinking about research integrity. Over the course of the past decade, the global conferences have reflected and documented signifi­cant changes in the way research integrity is viewed and supported” The Inter-American Network, formed at the 6th WCRI held in Hong Kong, China with members from Brazil, Colombia, Peru, Chile, and the US has contributed to raising awareness of research integrity issues in Latin America. The network established standards for the responsible conduct of research through the joint project “Generation of Recommendations in Scientific Integrity” and has undertaken the translation to Spanish of the Hong Kong Principles, among other initiatives. The participation of Peruvians in the WCRIs has catalyzed the sharing of knowledge in Peru. Such sharing has been reflected in meetings and events to discuss research integrity, formation of networks, and published articles by Peruvians on plagiarism, predatory journals, good practices, and other topics. Unfortunately, only a few representatives from Latin America have participated thus far in WCRIs, networks, and local events. Thus, we believe more space should be created, particularly in Peru and other countries where systems for research integrity are still being established. Such space should offer a safe place to share experiences, initiatives, and concerns about research and academic integrity. Perhaps most important is coming together to conduct training, reinforce mentoring opportunities, and enhance mechanisms for investigating misconduct and promoting integrity in Peru and across Latin America

Eventos adversos en el perioperatorio relacionados con el uso de bloqueantes neuromusculares comparado con no utilizarlos durante la anestesia general en adultos : revisión sistemática de la literatura

Introducción: Los bloqueadores neuromusculares (BNM) son de uso rutinario en anestesia pese a que no poseen propiedades anestésicas y se han asociado con eventos adversos y mortalidad. Muchas cirugías, incluso abdominales pueden ejecutarse sin BNM. Poco se ha profundizado en el exceso de riesgo de usarlos frente a omitirlos. Indicarlos en situaciones específicas puede disminuir eventos adversos y costo de la anestesia. Objetivo: Estimar la seguridad relativa en el perioperatorio de pacientes adultos sometidos a procedimientos quirúrgicos con anestesia general que han recibido BNM con respecto a aquellos que han recibido otras técnicas anestésicas que no incluyen BNM. Métodos: Revisión Sistemática de la Literatura. Criterios de Selección: Ensayos Clínicos o estudios observacionales en adultos sometidos a cirugías que requieran anestesia general, que reporten eventos adversos en el perioperatorio, con el uso y sin el uso de BNM. Fueron excluidos estudios en niños, pacientes obesos, embarazadas, traumatizados o sometidos a cirugía cardíaca. Búsqueda y Selección de artículos: En los últimos 15 años en PubMed, EMBASE, LILACS, Cochrane y literatura gris, sin exclusión de idiomas, usando términos y sinónimos Decs, Mesh o Emtree, con la estrategia de búsqueda usando términos: “Anaesthesia” (P) + “Neuromuscular Blocking Agent” (I) + “Adverse events” (D), incluyendo todos los sinónimos de interés. Se establecieron límites de fecha de publicación y edad. Se evaluaron ensayos clínicos y estudios observacionales de manera separada para definir la viabilidad de un metanálisis. Se aplicó el flujograma y la lista de chequeo PRISMA (Preferred Items for Systematic Reviews and Metanalisis). Antes de iniciar la búsqueda, el protocolo fue registrado en PROSPERO, con el número CRD42019128550, realizando solo, modificación en la estrategia de búsqueda y notificada a PROSPERO. La búsqueda se realizó el 18 de mayo de 2019. Se excluyeron estudios que no abordaban la pregunta o comparación de interés, así como aquellos que cumplieran criterios de exclusión. La calidad de los estudios fue evaluada usando CONSORT, STROBE, New Castle-Ottawa y la herramienta de riesgo de sesgos de Cochrane. Recolección de datos y análisis: Se utilizó Mendeley como gestor bibliográfico, tres revisores independientemente evaluaron la calidad. Los desacuerdos fueron resueltos por un cuarto revisor. Se utilizó Review Manager 5 para la extracción y análisis de datos. Se midió la frecuencia de eventos adversos, clasificándolos así: complicaciones respiratorias, despertar intraoperatorio y anafilaxia, así como la frecuencia de recurarización residual en los estudios seleccionados. Riesgo relativo y otras medidas fueron calculadas según la información disponible y homogeneidad de estudios. La calidad de la evidencia fue valorada por el sistema GRADE. Resultados: Se encontraron 433 estudios después de remover duplicados. Se seleccionaron 7 estudios, 4 de ellos observacionales con buena concordancia y calidad. Se realizó metanálisis de 4 estudios de cohortes prospectivos, encontrando un riesgo incrementado de complicaciones respiratorias cuando se usan BNM. (RR: 2,71 con IC95% 1,99-3,69). Otros eventos adversos de interés no pudieron ser evaluados. Conclusiones: Hay evidencia de calidad moderada que sugiere que existe un riesgo incrementado de complicaciones respiratorias postoperatorias cuando se usan BNM. Para establecer causalidad, deben realizarse estudios controlados.Introduction: Neuromuscular Blockers Agents (NMBA) are routinely used in anaesthesia, although they don´t have anaesthetic properties and adverse events and mortality have been reported. Muscular relaxation is more a result of quality of anaesthesia that a muscular paralysis. Like this, abdominal surgeries are realized under anaesthesia without NMBA. Efforts made to avoid Postoperative Residual Curarization and intraoperative awareness have not diminished their incidence, and risk of use NMBA is not established. Judicious use of NMBA in specific situations may decrease adverse effects and cost of anaesthesia. Objective: Make a comparison of frequency of adverse events on perioperative period of adult patients, who suffer surgical procedures under general anaesthesia, in whose received NMBA with respect those received other techniques without NMBA. Methods: Systematic Review of literature. Eligibility criteria: Clinical trial if were published, observational studies in adults with surgery that reporting adverse events and mortality during perioperative period with use or without NMBAs. Studies on paediatric or obese patient, trauma, obstetric and cardiac surgery were excluded. Search and select Methods: Last fifteen years in PubMed, EMBASE, LILACS, Cochrane, and grey literature, without exclusion languages, seeking with Decs, Mesh, emtree and synonymous. Search strategy was: "Anaesthesia" (P) + "Neuromuscular Blocking Agents" (I) + “Adverse Effects” (O), including synonymous. We will use PRISMA (Preferred Items for Systematic Reviews and Metanalysis) flow chart and checklist. The protocol was registered on PROSPERO with the number CRD42019128550 and only was modified search strategy before beginning. Collect and analysis: Mendeley will be selected as reference manager. Independently, three reviewers seemed, selected and evaluated quality of articles. In disagreement case, a fourth reviewer decided. PRISMA checklist will be used to design of review, Review Manager 5 to analyse cuantitative data. Frequency of adverse events was measured, incidence of residual neuromuscular blockade, relative risk and others according information available and homogeneity of studies. Checklist CONSORT, STROBE, New Castle-Ottawa and risk of bias tool of Cochrane and GRADE System for certainty of evidence. Results: 433 studies were founded after duplicated to be removed. Seven studies were select, and four of them, observational studies with good agreement, methodological and report quality. Metanalysis of four prospective cohort studies were performed, finding an increased risk of postoperative respiratory complications when using NMBA (RR: 2,71 with IC95% 1,99-3,69). Other adverse events of interest could not be evaluated. Conclusions: There is evidence that suggest an increased risk of postoperative respiratory complications when NMBA were used. To establish causality, controlled trials should be performed. There is not enough information about other adverse events.2019-10-25 10:50:01: Script de automatizacion de embargos. No se encontró correo, se envío correo al autor: Cordial saludo respetado autor:Se ha realizado la publicación de su documento " Eventos adversos en el perioperatorio relacionados con el uso de bloqueantes neuromusculares comparado con no utilizarlos durante la anestesia general en adultos : revisión sistemática de la literatura " en el Repositorio Institucional EdocUR de la Universidad del Rosario. Usted escogió la opción "Restringido (Temporalmente bloqueado)", por lo que el documento ha quedado con embargo hasta el 26 de octubre de 2021, en concordancia con las Políticas de Acceso Abierto de la Universidad. Si usted desea dejarlo con acceso abierto antes de finalizar dicho periodo o si por el contrario desea extender el embargo al finalizar este tiempo, puede enviar un correo a esta misma dirección realizando la solicitud. Tenga en cuenta que los documentos en acceso abierto propician una mayor visibilidad de su producción académica y científica. Quedo atento a cualquier inquietud o sugerencia"2021-10-26 01:01:01: Script de automatizacion de embargos. info:eu-repo/date/embargoEnd/2021-10-2

Nifurtimox versus benznidazole or placebo for asymptomatic Trypanosoma cruzi infection (Equivalence of Usual Interventions for Trypanosomiasis - EQUITY): Study protocol for a randomised controlled trial

Background: Either benznidazole (BZN) or nifurtimox (NFX) is recommended as equivalent to treat Trypanosoma cruzi infection. Nonetheless, supportive data from randomised trials is limited to individuals treated with BZN in southern cone countries of Latin America. Methods: The goal of this randomised, concealed, blind, parallel-group trial is to inform the trypanocidal efficacy and safety of NFX and its equivalence to BZN among individuals with T. cruzi positive serology (TC+). Eligible individuals are TC+, 20-65 years old, with no apparent symptoms/signs or uncontrolled risk factors for cardiomyopathy and at negligible risk of re-infection. Consenting individuals (adherent to a 10-day placebo run-in phase) receive a 120-day BID blinded treatment with NFX, BZN or matching placebo (2:2:1 ratio). The four active medication arms include (1) a randomly allocated sequence of 60-day, conventional-dose (60CD) regimes (BZN 300 mg/day or NFX 480 mg/day, ratio 1:1), followed or preceded by a 60-day placebo treatment, or (2) 120-day half-dose (120HD) regimes (BZN 150 mg/day or NFX 240 mg/day, ratio 1:1). The primary efficacy outcome is the proportion of participants testing positive at least once for up to three polymerase chain reaction (PCR) assays (1 + PCR) 12-18 months after randomisation. A composite safety outcome includes moderate to severe adverse reactions, consistent blood marker abnormalities or treatment abandons. The trial outside Colombia (expected to recruit at least 60% of participants) is pragmatic; it may be open-label and not include all treatment groups, but it must adhere to the randomisation and data administration system and guarantee a blinded efficacy outcome evaluation. Our main comparisons include NFX groups with placebo (for superiority), NFX versus BZN groups and 60CD versus 120HD groups (for non-inferiority) and testing for the agent-dose and group-region interactions. Assuming a 1 + PCR ? 75% in the placebo group, up to 25% among BZN-treated and an absolute difference of up to ? 25% with NFX to claim its trypanocidal effect, 60-80 participants per group (at least 300 from Colombia) are needed to test our hypotheses (80-90% power; one-sided alpha level 1%). Discussion: The EQUITY trial will inform the trypanocidal effect and equivalence of nitroderivative agents NFX and BZN, particularly outside southern cone countries. Its results may challenge current recommendations and inform choices for these agents. Trial registration: ClinicalTrials.gov, NCT02369978. Registered on 24 February 2015. © 2019 The Author(s)

Eventos adversos en el perioperatorio relacionados con el uso de bloqueantes neuromusculares comparado con no utilizarlos durante la anestesia general en adultos : revisión sistemática de la literatura

Introducción: Los bloqueadores neuromusculares (BNM) son de uso rutinario en anestesia pese a que no poseen propiedades anestésicas y se han asociado con eventos adversos y mortalidad. Muchas cirugías, incluso abdominales pueden ejecutarse sin BNM. Poco se ha profundizado en el exceso de riesgo de usarlos frente a omitirlos. Indicarlos en situaciones específicas puede disminuir eventos adversos y costo de la anestesia. Objetivo: Estimar la seguridad relativa en el perioperatorio de pacientes adultos sometidos a procedimientos quirúrgicos con anestesia general que han recibido BNM con respecto a aquellos que han recibido otras técnicas anestésicas que no incluyen BNM. Métodos: Revisión Sistemática de la Literatura. Criterios de Selección: Ensayos Clínicos o estudios observacionales en adultos sometidos a cirugías que requieran anestesia general, que reporten eventos adversos en el perioperatorio, con el uso y sin el uso de BNM. Fueron excluidos estudios en niños, pacientes obesos, embarazadas, traumatizados o sometidos a cirugía cardíaca. Búsqueda y Selección de artículos: En los últimos 15 años en PubMed, EMBASE, LILACS, Cochrane y literatura gris, sin exclusión de idiomas, usando términos y sinónimos Decs, Mesh o Emtree, con la estrategia de búsqueda usando términos: “Anaesthesia” (P) + “Neuromuscular Blocking Agent” (I) + “Adverse events” (D), incluyendo todos los sinónimos de interés. Se establecieron límites de fecha de publicación y edad. Se evaluaron ensayos clínicos y estudios observacionales de manera separada para definir la viabilidad de un metanálisis. Se aplicó el flujograma y la lista de chequeo PRISMA (Preferred Items for Systematic Reviews and Metanalisis). Antes de iniciar la búsqueda, el protocolo fue registrado en PROSPERO, con el número CRD42019128550, realizando solo, modificación en la estrategia de búsqueda y notificada a PROSPERO. La búsqueda se realizó el 18 de mayo de 2019. Se excluyeron estudios que no abordaban la pregunta o comparación de interés, así como aquellos que cumplieran criterios de exclusión. La calidad de los estudios fue evaluada usando CONSORT, STROBE, New Castle-Ottawa y la herramienta de riesgo de sesgos de Cochrane. Recolección de datos y análisis: Se utilizó Mendeley como gestor bibliográfico, tres revisores independientemente evaluaron la calidad. Los desacuerdos fueron resueltos por un cuarto revisor. Se utilizó Review Manager 5 para la extracción y análisis de datos. Se midió la frecuencia de eventos adversos, clasificándolos así: complicaciones respiratorias, despertar intraoperatorio y anafilaxia, así como la frecuencia de recurarización residual en los estudios seleccionados. Riesgo relativo y otras medidas fueron calculadas según la información disponible y homogeneidad de estudios. La calidad de la evidencia fue valorada por el sistema GRADE. Resultados: Se encontraron 433 estudios después de remover duplicados. Se seleccionaron 7 estudios, 4 de ellos observacionales con buena concordancia y calidad. Se realizó metanálisis de 4 estudios de cohortes prospectivos, encontrando un riesgo incrementado de complicaciones respiratorias cuando se usan BNM. (RR: 2,71 con IC95% 1,99-3,69). Otros eventos adversos de interés no pudieron ser evaluados. Conclusiones: Hay evidencia de calidad moderada que sugiere que existe un riesgo incrementado de complicaciones respiratorias postoperatorias cuando se usan BNM. Para establecer causalidad, deben realizarse estudios controlados.Introduction: Neuromuscular Blockers Agents (NMBA) are routinely used in anaesthesia, although they don´t have anaesthetic properties and adverse events and mortality have been reported. Muscular relaxation is more a result of quality of anaesthesia that a muscular paralysis. Like this, abdominal surgeries are realized under anaesthesia without NMBA. Efforts made to avoid Postoperative Residual Curarization and intraoperative awareness have not diminished their incidence, and risk of use NMBA is not established. Judicious use of NMBA in specific situations may decrease adverse effects and cost of anaesthesia. Objective: Make a comparison of frequency of adverse events on perioperative period of adult patients, who suffer surgical procedures under general anaesthesia, in whose received NMBA with respect those received other techniques without NMBA. Methods: Systematic Review of literature. Eligibility criteria: Clinical trial if were published, observational studies in adults with surgery that reporting adverse events and mortality during perioperative period with use or without NMBAs. Studies on paediatric or obese patient, trauma, obstetric and cardiac surgery were excluded. Search and select Methods: Last fifteen years in PubMed, EMBASE, LILACS, Cochrane, and grey literature, without exclusion languages, seeking with Decs, Mesh, emtree and synonymous. Search strategy was: "Anaesthesia" (P) + "Neuromuscular Blocking Agents" (I) + “Adverse Effects” (O), including synonymous. We will use PRISMA (Preferred Items for Systematic Reviews and Metanalysis) flow chart and checklist. The protocol was registered on PROSPERO with the number CRD42019128550 and only was modified search strategy before beginning. Collect and analysis: Mendeley will be selected as reference manager. Independently, three reviewers seemed, selected and evaluated quality of articles. In disagreement case, a fourth reviewer decided. PRISMA checklist will be used to design of review, Review Manager 5 to analyse cuantitative data. Frequency of adverse events was measured, incidence of residual neuromuscular blockade, relative risk and others according information available and homogeneity of studies. Checklist CONSORT, STROBE, New Castle-Ottawa and risk of bias tool of Cochrane and GRADE System for certainty of evidence. Results: 433 studies were founded after duplicated to be removed. Seven studies were select, and four of them, observational studies with good agreement, methodological and report quality. Metanalysis of four prospective cohort studies were performed, finding an increased risk of postoperative respiratory complications when using NMBA (RR: 2,71 with IC95% 1,99-3,69). Other adverse events of interest could not be evaluated. Conclusions: There is evidence that suggest an increased risk of postoperative respiratory complications when NMBA were used. To establish causality, controlled trials should be performed. There is not enough information about other adverse events

Estado de la urología reconstructiva en Colombia : tratamiento de la estrechez uretral anterior, una encuesta nacional

The minimally invasive treatment of urethral stricture has higher recurrence and longterm re operation rates. Surveys in other countries have shown that urologists have little experience with open urethroplasty with a preference to the utilization of miniQ4Revista Nacional - IndexadaCN

Demographic, clinical, and functional determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation

Altres ajuts: Alliance Bristol-Myers Squibb/Pfizer.Background: This study assessed the sociodemographic, functional, and clinical determinants of antithrombotic treatment in patients with nonvalvular atrial fibrillation (NVAF) attended in the internal medicine setting. Methods: A multicenter, cross-sectional study was conducted in NVAF patients who attended internal medicine departments for either a routine visit (outpatients) or hospitalization (inpatients). Results: A total of 961 patients were evaluated. Their antithrombotic management included: no treatment (4.7%), vitamin K antagonists (VKAs) (59.6%), direct oral anticoagulants (DOACs) (21.6%), antiplatelets (6.6%), and antiplatelets plus anticoagulants (7.5%). Permanent NVAF and congestive heart failure were associated with preferential use of oral anticoagulation over antiplatelets, while intermediate-to high-mortality risk according to the PROFUND index was associated with a higher likelihood of using antiplatelet therapy instead of oral anticoagulation. Longer disease duration and institutionalization were identified as determinants of VKA use over DOACs. Female gender, higher education, and having suffered a stroke determined a preferential use of DOACs. Conclusions: This real-world study showed that most elderly NVAF patients received oral anticoagulation, mainly VKAs, while DOACs remained underused. Antiplatelets were still offered to a proportion of patients. Longer duration of NVAF and institutionalization were identified as determinants of VKA use over DOACs. A poor prognosis according to the PROFUND index was identified as a factor preventing the use of oral anticoagulation

Compilación de Proyectos de Investigacion de 1984-2002

Instituto Politecnico Nacional. UPIICS