Características de los grados de afectación del nervio facial y la discapacidad facial en pacientes con parálisis facial periférica de un año de evolución. Instituto Nacional de Ciencias Neurológicas. Marzo-junio 2015

OBJETIVOS: Determinar las características de los grados de afectación del nervio facial y la relación con la discapacidad facial en pacientes con parálisis facial periférica de un año de evolución. MATERIALES Y MÉTODOS: Estudio de tipo Observacional, correlacional, transversal. Se estudió una población de pacientes con diagnóstico de parálisis facial periférica durante el año 2014. Se seleccionó una muestra inicial de 56 pacientes a través de historias clínicas. Los criterios de inclusión fueron pacientes con lesión nerviosa del tipo axonotmesis (clasificación de Seddon), ser mayores de 18 años, sin antecedentes de parálisis facial periférica, sin alteración de la capacidad mental o haber recibido tratamiento por toxina botulínica. Se evaluó a 43 de ellos 22 mujeres y 21 varones, usando la escala House-Brackmann 2.0 y el Índice de Discapacidad Facial, posteriormente se describieron las características según sexo, edad y se determinó la relación entre ambas medidas de evaluación usando el coeficiente correlación de Pearson. RESULTADOS: Se encontró una fuerte correlación entre los grados de afectación del nervio facial y el Índice de discapacidad facial subescala física (r= -0.85, p< 0,001), para los grados de afectación del nervio facial y el índice de discapacidad facial subescala social (r= -0.74, p<0,001). Los participantes mayores de 60 años reflejaron puntajes superiores en el grado de afectación nerviosa y mayor discapacidad facial. Así mismo no se halló diferencia. mportante entre varones y mujeres para los grados de afectación del nervio facial. CONCLUSIONES: Se demostró la correlación negativa entre los grados de afectación del nervio facial y la Discapacidad Facial, a mayor grado de afección nerviosa facial se obtendrá puntajes inferiores en el cuestionario de autoevaluación de discapacidad. La inclusión de estas herramientas en la evaluación fisioterapéutica permitiría conocer además los cambios físicosociales que conllevan a la discapacidad como producto de la lesión facial. PALABRAS CLAVE: Parálisis Facial Periférica, Índice de Discapacidad Facial, House-Brackmann Facial Nerve Grading system 2.0--- OBJECTIVES: To determine the characteristics of the degrees of affection of the facial nerve and the relation with disability in patients with facial paralysis with 1 year of evolution. MATERIALS AND METHODS: Observational, correlational, and crosssectional study. A population of patients diagnosed with peripheral facial paralysis was studied during 2014. A first sample of 56 patients was chose through clinical records. Inclusion criteria were: patients with Axonotmesis type injury (Seddon’s classification), older than 18 years, without history of peripheral facial paralysis, not mental capacity disorder or having received treatment for botulinum toxin. 43 of them were evaluated – 21 women and 22 men – using the Facial Nerve Grading System 2.0 (FNGS2.0) and the Facial Disability Index. Characteristics according to sex and age were subsequently described and the relation between both evaluation measures was determined using the Pearson correlation coefficient. RESULTS: A strong correlation between the degrees of affection of facial nerve and Facial Disability Index for the physical subscale was found, (r= -0.85, p< 0,001) for the degrees of affection of the facial nerve and the Facial Disability Index for social subscale (r= -0.74, p<0,001). The participants older than 60 years reflected higher scores in the degrees of affection and a higher facial disability. In addition, there were no differences between degrees of affection in men and women. CONCLUSIONS: The level of nerve affection is associated with facial disability. And this association is higher with the physic disability dimension. Including these tools in physiotherapeutic evaluation would make possible to acknowledge physical and social changes that lead to disability as a result of facial nerve injury. KEY WORDS: Peripheral Facial Paralysis, Facial Disability Index, Facial Nerve Grading System 2.0.Tesi

Association between C-Reactive protein and metabolic Syndrome in the Peruvian population of the Peru Migrant study

Introducción: El síndrome metabólico (MetS) es un grupo de factores de riesgo cardiovascular que se caracteriza por la presencia de inflamación crónica de bajo grado. Entre todos los biomarcadores inflamatorios asociados al MetS, el mejor caracterizado y bien estandarizado es la proteína C-Reactiva (PCR). Objetivo: Evaluar la asociación entre la proteína C-Reactiva y el síndrome metabólico en la población peruana del estudio PERU MIGRANT. Métodos: Estudio transversal analítico. Análisis de base de datos secundario del estudio PERU MIGRANT. Se consideró MetS según los criterios de Harmonizing the Metabolic Syndrome. Para la PCR, se dispuso un punto de corte ≥ 3 mg/L. Se usó modelos lineales generalizados de familia de Poisson para hallar la razón de prevalencias cruda y ajustada. Resultados: Se trabajó con un total de 958 sujetos. La prevalencia de MetS fue de 24,53%. En el análisis de regresión simple, se encontró que las personas con niveles altos de PCR tenían 75% mayor frecuencia de tener MetS, en comparación a quienes no presentaban niveles altos de PCR (RP=2,21, IC95%: 1,40 – 2,18). En la regresión múltiple, se observó que los pacientes con niveles altos de PCR tenían 31% mayor frecuencia de tener MetS, respecto a quienes presentaban niveles normales de PCR; ajustando por el resto de covariables (RP=1,31, IC95%: 1,05 – 1,62). Conclusiones: La PCR plasmática se asoció positivamente con MetS. Ello sugiere que un proceso inflamatorio de bajo grado puede estar relacionado con la presencia de MetS.Introduction: Metabolic syndrome (MetS) is a group of cardiovascular risk factors characterized by the presence of low-grade chronic inflammation. Among all the inflammatory biomarkers associated with MetS, the best characterized and well standardized is C-Reactive protein (CRP). Objectives: To evaluate the association between C-Reactive protein and metabolic syndrome in the Peruvian population of the PERU MIGRANT study. Methods: Secondary database analysis of the PERU MIGRANT study. MetS was considered according to the Harmonizing the Metabolic Syndrome criteria. For CRP, a cutoff point of ≥ 3 mg/L was established. Results: We worked with a total of 958 subjects. The prevalence of MetS was 24.53%. In the simple regression analysis, it was found that people with high CRP levels had a 75% higher frequency of having MetS, compared to those who did not present high CRP levels (PR = 2.21, 95% CI: 1.40 - 2.18). In multiple regression, it was observed that patients with high CRP levels had a 31% greater frequency of having MetS, compared to those with normal CRP levels; adjusting for the rest of the covariates (PR = 1.31, 95% CI: 1.05 - 1.62). Conclusions: Plasma CRP was positively associated with MetS. This suggests that a low-grade inflammatory process may be related to the presence of MetS. Against this, physicians should pay attention to glucose, lipid profile, and central obesity in patients with elevated plasma CRP levels.Campus Lima Nort

Predictive Power of a Body Shape Index (ABSI) for Diabetes Mellitus and Arterial Hypertension in Peru: Demographic and Health Survey Analysis - 2020

Introduction: Given the relationship between obesity and type 2 diabetes mellitus (T2DM) and hypertension, an indicator of body fat, A Body Shape Index (ABSI), has been considered to have apparent predictive power for these diseases. Objective: To determine the predictive power of the ABSI for DMT2 and hypertension in Peru through the analysis of the Demographic and Health Survey-2020 (ENDES-by its acronym in Spanish-2020). Methods: Cross-sectional analytical study of the ENDES-2020. The variables evaluated were ABSI, body mass index, high abdominal waist, waist-to-height ratio, body roundness index (BRI) and conicity index (COI). Areas under the curves (AUC) together with their 95% confidence interval (95%CI) were used to present each index. Results: A total of 19 984 subjects were studied. Regarding hypertension, the highest AUC was presented by the COI: AUC=0.707 (95%CI 0.694-0.719). While the ABSI obtained the penultimate place: AUC=0.702 (95% CI 0.689-0.715). In case of DM2, the highest ABC was presented by BRI: AUC=0.716 (95%CI 0.689-0.743); while ABSI obtained the second place: AUC=0.687 (95%CI 0.658-0.717). Conclusions: The results demonstrate that ABSI is not a good predictor for hypertension and DMT2 in the Peruvian population. If these findings are confirmed by other studies, its use would not be recommended for these diseases, and other anthropometric indicators that could perform better should be further explored

Predictive power of a body shape index (ABSI) for diabetes mellitus and arterial hypertension in Peru: demographic and health survey analysis - 2020

Introduction: Given the relationship between obesity and type 2 diabetes mellitus (T2DM) and hypertension, an indicator of body fat, A Body Shape Index (ABSI), has been considered to have apparent predictive power for these diseases.Objective: To determine the predictive power of the ABSI for DMT2 and hypertension in Peru through the analysis of the Demographic and Health Survey-2020 (ENDES-by its acronym in Spanish-2020).Methods: Cross-sectional analytical study of the ENDES-2020. The variables evaluated were ABSI, body mass index, high abdominal waist, waist-to-height ratio, body roundness index (BRI) and conicity index (COI). Areas under the curves (AUC) together with their 95% confidence interval (95%CI) were used to present each index.Results: A total of 19 984 subjects were studied. Regarding hypertension, the highest AUC was presented by the COI: AUC=0.707 (95%CI 0.694-0.719). While the ABSI obtained the penultimate place: AUC=0.702 (95% CI 0.689-0.715). In case of DM2, the highest ABC was presented by BRI: AUC=0.716 (95%CI 0.689-0.743); while ABSI obtained the second place: AUC=0.687 (95%CI 0.658-0.717). Conclusions: The results demonstrate that ABSI is not a good predictor for hypertension and DMT2 in the Peruvian population. If these findings are confirmed by other studies, its use would not be recommended for these diseases, and other anthropometric indicators that could perform better should be further explored.Campus Lima Nort

Hearing loss due to noise exposure and its relationship with hypertension in Peruvian workers

Introduction:Noise-induced hearing loss has been implicated in the genesis of several chronic conditions; however, its behavior concerning hypertension still raises doubts about it.Objective:to determine the association between hearing loss due to exposure to noise and the presence of hypertension in a sample of Peruvian workers.Methods: Cross-sectional analytical study. Secondary analysis of the occupational database of a Medical centerin Lima, Peru. hypertensionwas measured by self-report and clinical method. Hearing loss was classified as none, mild, moderate and severe. For the regression analysis, Poisson was performed with robust variance, obtaining crude (PRc) and adjusted (PRa) prevalence ratios.Results: We worked with a total of 1987 participants. The prevalence of hypertension was 15.40% and hearing loss was 36.39%. For the multivariate regression analysis, a statistically significant association with hypertension was found in those with mild hearing loss (PRa=1.52; CI95% 1.06–2.10), moderate (PRa=2.70; CI95% 1,93–3.76) and severe (PRa=3.82; 95% CI 2.56–5.96), compared to those without hearing loss.Conclusions:Hearing loss due to exposure to occupational noise was associated with the presence of hypertension. Although this study is only a first overview of the relationship that both variables could have, it is recommended to continue promoting policies and awareness campaigns to prevent hearing loss in workers, and thus avoid complications related to it in the long term.Campus Lima Nort

Hearing Loss due to Noise Exposure and its Relationship with Hypertension in Peruvian Workers

Introduction: Noise-induced hearing loss has been implicated in the genesis of several chronic conditions; however, its behavior concerning hypertension still raises doubts about it. Objective: to determine the association between hearing loss due to exposure to noise and the presence of hypertension in a sample of Peruvian workers. Methods: Cross-sectional analytical study. Secondary analysis of the occupational database of a Medical center in Lima, Peru. hypertension was measured by self-report and clinical method. Hearing loss was classified as none, mild, moderate and severe. For the regression analysis, Poisson was performed with robust variance, obtaining crude (PRc) and adjusted (PRa) prevalence ratios. Results: We worked with a total of 1987 participants. The prevalence of hypertension was 15.40% and hearing loss was 36.39%. For the multivariate regression analysis, a statistically significant association with hypertension was found in those with mild hearing loss (PRa=1.52; CI95% 1.06–2.10), moderate (PRa=2.70; CI95% 1,93–3.76) and severe (PRa=3.82; 95% CI 2.56–5.96), compared to those without hearing loss. Conclusions: Hearing loss due to exposure to occupational noise was associated with the presence of hypertension. Although this study is only a first overview of the relationship that both variables could have, it is recommended to continue promoting policies and awareness campaigns to prevent hearing loss in workers, and thus avoid complications related to it in the long term

Analysis of statistical knowledge of Peruvian medical students: a cross-sectional analytical study based on a survey

Introduction: Despite the growing awareness of the importance of knowledge in biostatistics, many investigations worldwide have found that medical students have a poor understanding of it. Objective: To determine the percentage of Peruvian medical students with sufficient biostatistics knowledge and the associated factors. Methods: Cross-sectional analytical study. Application of a virtual survey to medical students from different faculties in Peru. Results: 56.46% of medical students have insufficient knowledge of biostatistics. A statistically significant association was found for those who were 25 years of age or older (aPR: 1.195; 95% CI 1.045 - 1.366; p=0.009); being between the 9th and 12th semester (aPR: 1.177; 95% CI 1.001 - 1.378; p=0.037) and medical internship (aPR: 1.373; 95% CI 1.104 - 1.707; p=0.004); take an external course in biostatistics, epidemiology or research (aPR: 4.016; 95% CI 3.438 - 4.693; p<0.001); having read more than 12 articles per year (aPR: 1.590; 95% CI 1.313 - 1.967; p<0.001); and publish at least one scientific article (aPR: 1.549; 95% CI 1.321 - 1.816; p<0.001) or more than one (PR: 2.312; 95% CI 1.832 - 2.919; p<0.001). Conclusions: There is insufficient knowledge of biostatistics in medical students. The factors associated with a good understanding of this were age, academic semester, the number of articles read and published, and having taken an external course.Campus Lima Nort

Analysis of Statistical Knowledge of Peruvian Medical Students: A Cross-Sectional Analytical Study Based on a Survey

Introduction: Despite the growing awareness of the importance of knowledge in biostatistics, many investigations worldwide have found that medical students have a poor understanding of it. Objective: To determine the percentage of Peruvian medical students with sufficient biostatistics knowledge and the associated factors. Methods: Cross-sectional analytical study. Application of a virtual survey to medical students from different faculties in Peru. Results: 56.46% of medical students have insufficient knowledge of biostatistics. A statistically significant association was found for those who were 25 years of age or older (aPR: 1.195; 95% CI 1.045 - 1.366; p=0.009); being between the 9th and 12th semester (aPR: 1.177; 95% CI 1.001 - 1.378; p=0.037) and medical internship (aPR: 1.373; 95% CI 1.104 - 1.707; p=0.004); take an external course in biostatistics, epidemiology or research (aPR: 4.016; 95% CI 3.438 - 4.693; p&lt;0.001); having read more than 12 articles per year (aPR: 1.590; 95% CI 1.313 - 1.967; p&lt;0.001); and publish at least one scientific article (aPR: 1.549; 95% CI 1.321 - 1.816; p&lt;0.001) or more than one (PR: 2.312; 95% CI 1.832 - 2.919; p&lt;0.001). Conclusions: There is insufficient knowledge of biostatistics in medical students. The factors associated with a good understanding of this were age, academic semester, the number of articles read and published, and having taken an external course

Factors associated with knowledge of p-value in a sample of medical students

ABSTRACT Introduction: The role of p-value knowledge for clinical practice is elemental; however, insufficient evidence on this is found in health science students. Objective: To determine the factors associated with p-value knowledge in human medical students. Methods: Analytical cross-sectional study. Application of a virtual survey to human medicine students from different faculties in Peru. Results: 54.69% had sufficient knowledge of p-value. The multivariate analysis found a statistically significant association with having sufficient knowledge on this topic in those who were between 6th to 9th semester (APr: 1.118; 95% CI 1.051 - 1.412; p=0.009) and medical internship (APr: 1.234; 95% CI 1.073 - 1.418; p=0.003); taking an external course in biostatistics, epidemiology or research (APr: 1.420; 95% CI 1.227 - 1.643; p<0.001); having read 6 to 12 articles per year (APr: 1.353; 95% CI 1.196 - 1.530; p<0.001) and more than 12 articles per year (APr: 1.590; 95% CI 1.313 - 1.967; p<0.001); and publishing at least one scientific article (APr: 1.397; 95% CI 1.199 - 1.628; p<0.001) or more than one (APr:1.424; 95% CI 1.196 - 1.696; p<0.001). Conclusion: It was found that the academic semester, having taken an external course, having read more than 6 articles per year and having published at least one scientific article are independently associated with having greater understanding of this topic

Factores asociados al cribado de Diabetes Mellitus en población Peruana ¿problema para la salud pública?

Highlights: El ser varón es un factor relevante asociado al no tamizaje de diabetes mellitus tipo 2 (DM2). Un mayor nivel de educación y socioeconómico se asocian positivamente con la posibilidad de realizarse tamizaje para DM2 El fortalecimiento de los servicios de atención primaria es crucial en la prevención primaria de DM2 a través del tamizaje. Introducción: La Diabetes Mellitus tipo 2 es una enfermedad que representa un reto para la salud pública por su tendencia al crecimiento e impacto sobre todo en países en desarrollo. Objetivo: determinar los factores asociados a la no realización del cribado de diabetes mellitus tipo 2 según la encuesta demográfica y de salud familiar del año 2020 (ENDES-2020). Materiales y métodos: Estudio analítico transversal secundario de la ENDES-2020. Resultados: Las variables que mostraron asociación estadísticamente significativa para cribado de DM2 fueron: sexo masculino (PR=1,06, IC95% 1,02–1,10; p<0,001), edad entre 30 a 59 años (0,92; IC95% 0,89–0,95; p<0,001) y 60 años a más (PR=0,72; IC95% 0,65–0,79; p<0,001), educación primaria (PR=0,94, IC 95% 0,92 - 0,99; p<0,020), secundaria (PR=0,93; IC 95% 0,88–0,97; p=0,008) y superior (PR=0,86, IC 95% 0,85–0,94; p<0,001), ser pobre (PR=0,96, IC95% 0,92–0,99; p=0,016), medio (PR=0,93; IC95% 0,88 – 0,96; p=0,001), rico (PR=0,89; IC95% 0,84 – 0,94; p<0,001), muy rico (PR=0,81; IC95% 0,75–0,86; p<0,001), e hipertensión (PR=0,91; IC 95% 0,867–0,969; p=0,002). Discusión: El sexo masculino fue el único factor asociado a la no realización del cribado de diabetes mellitus tipo 2, mientras que, pertenecer a un grupo de edad mayor, tener hipertensión arterial, mayor nivel educativo y socioeconómico aumentó la posibilidad de realizarlo. Conclusión: Es imprescindible reforzar las estrategias de cribado en el primer nivel de atención, mediante la implementación de medidas de prevención. Como citar este artículo: Fiorella Trujillo Minaya, Vera-Ponce Victor Juan, Torres-Malca Jenny Raquel, Zuzunaga-Montoya Fiorella E, Guerra Valencia Jamee, De la Cruz-Vargas Jhony A, Cruz Ausejo Liliana. Factores asociados al cribado de diabetes mellitus en población peruana ¿problema para la salud pública?. Revista Cuidarte. 2023;14(1):e2792. http://dx.doi.org/10.15649/cuidarte.279