Paciente varón con presentación atípica de púrpura de Henoch-Schönlein

Henoch-Schönlein purpura is the most common vasculitis in pediatric patients, characterized mainly by palpable purpura, abdominal pain, arthralgias, and kidney damage. Its presentation can be variable, delaying its diagnosis. We report a case of a 13-year-old male patient with an atypical presentation who arrives to the emergency department due to abdominal pain and purpuric lesions predominantly in lower limbs 5 days later the onset of the symptoms.La púrpura de Henoch- Schönlein es la vasculitis más común en los pacientes pediátricos, caracterizándose principalmente por la de púrpura palpable, dolor abdominal, artralgias y daño renal. Su presentación puede ser variable, pudiendo retrasar su diagnóstico. Se reporta el caso de un paciente de 13 años de sexo masculino con una presentación atípica quien acude a la emergencia por presentar dolor abdominal tipo punzante y 05 días después se agregaron lesiones purpúricas palpables a predominio de miembros inferiores

COVID-19 in Latin America and the Caribbean: what is known about the status of school reopening?

Since December 2019, the world has been facing a rapid increase in cases and deaths from the new coronavirus (COVID-19), forcing a response from countries all over the world to stop its transmission. Thus, at the beginning of April, 172 nations closed their schools, affecting >84.8% (~1484 million) of students enrolled worldwide,1 aiming to reduce the exposure to the virus, a social measure previously used to control the H1N1 influenza pandemic.2Revisión por pare

Inequalities in infant vaccination coverage during the COVID-19 pandemic: A population-based study in Peru

Objective: To identify the associated factors and assess the inequalities of full vaccination coverage (FVC) among Peruvian infants aged 12–23 months during the COVID-19 pandemic in a nationally representative sample. Methods: We carried out a population-based cross-sectional study based on a secondary data analysis using the 2021 Peruvian Demographic Health Survey (DHS) in infants aged 12 to 23 months. The sampling design was probabilistic, multistage, stratified, and independent at both departmental and area of residence levels. FVC was defined according to the WHO definition. We performed generalized linear models (GLM) Poisson family log link function to estimate crude (aPR) and adjusted prevalence ratios (aPR). Also, for inequality assessment, we calculated the concentration curve (CC), concentration index (CI), and Erreygers normalized concentration index (ECI). Results: We included 4,189 infants in our analysis. Nationwide, the prevalence of FVC was 66.19% (95% CI: 64.33–68). Being younger, having a mother with no education or primary education, belonging to a large family, having no access to mass media, having had six or fewer ANC visits, and having a mother whose age was under 20 at first delivery were inversely associated with FVC. Meanwhile, living in the Highlands or on the rest of the coast, and living in rural areas were directly associated with FVC. We found a pro-rich inequality in FVC based on wealth-ranked households (CI: 0.0066; ECI: 0.0175). Conclusion: FVC has dropped among Peruvian infants aged between 12 and 23 months. There were several factors associated with FVC. It was more concentrated among the better-off infants, although in low magnitude.Revisión por pare

Factors associated with the intention to participate in COVID-19 vaccine clinical trials: A cross-sectional study in Peru

Objective: To evaluate the factors associated with the intention to participate in COVID-19 vaccine clinical trials in the Peruvian population. Methods: Cross-sectional study and secondary analysis of a database that involved Peruvian population during September 2020. The Poisson regression model was used to estimate the associated factors. Results: Data from 3231 individuals were analyzed, 44.1% of whom intended to participate in COVID-19 vaccine clinical trials. Factors associated with the outcome were being male (RPa: 1.25; 95% CI: 1.15–1.35), being from the highlands region (RPa: 1.18; 95% CI: 1.09–1.28) or jungle (RPa: 1.30; 95% CI: 1.15–1.47), having a relative that is a healthcare professional (PRa: 1.16; 95% CI: 1.06–1.28), using a medical source of information (PRa: 1.28; 95% CI: 1.17–1.41), and trusting in the possible effectiveness of vaccines (PRa: 1.40; 95% CI: 1.29–1.51). The main reason for not participating in the trial was the possibility of developing side effects (69.80%). Conclusion: There is an urgent need to generate a perception of safety in COVID-19 vaccine clinical trials, to increase the population's intention to participate in these studies, and to provide evidence-based information about the vaccine.Revisión por pare

Prevention and control practices against Sars-Cov2 infection in the peruvian population

Objetive: To describe the prevention and control practices for the infection to SARS-COV2 in the Peruvian population. Material and Methods: Observational descriptive study. We evaluated a non-probabilistic sample of adult residents in some departments of Peru. Preventive practices were evaluated in people without a history of COVID-19 and control practices in people who had suffered it. Results: We evaluated 3630 Peruvians (mean age 25.4 ± 9.5), of that 3231 don't have a history of COVID-19 and 399 who had suffered it. The prevention and control practices that were realized often or always, with more frequencies, was the use of a mask when they go out home (97.9% vs 87.7), cover their nose or mouth when they sneeze (95.4% vs 89.9%), save the distance to other people in the street (91.4% vs 74.7%), wash their hands when they came home (92.5% vs 88.7%), and disinfect the objects and personal places (82.6% vs 77.4%). The 22.1% and 83.7%, the 59.7% and 80.2, and the 8.0% and 16.8% consumed some type of medicine, medicinal plant, and chlorine dioxide to prevent and control the infection, respectively. Conclusion: In general, less than 50% of the participants performed prevention and control practices against COVID-19 often or always.Revisión por pare

Association of lifetime E-cigarettes and/or tobacco with last year marijuana use in university students. Peru 2016

Solicitud de embargo por publicación en revista indexada.Antecedentes: El uso de cigarrillos electrónicos ha aumentado en los últimos años en el Perú, los cuales en conjunto con el tabaco aumentan la exposición de los jóvenes a nicotina. La marihuana es la droga ilícita mas consumida por los jovenes en el Perú. Objetivo: Identificar la asociación entre uso de cigarrillo electrónico y/o tabaco en la vida con consumo de marihuana en los últimos 12 meses. Material y métodos: Estudio transversal analítico secundario al III Estudio epidemiológico andino sobre consumo de drogas en la población universitaria de Perú, 2016 (EEACDU). Se realizó un análisis multivariado utilizando un modelo lineal generalizado de la familia y opción de enlace log Poisson, presentándose en forma de PR. Participantes: Estudiantes universitarios con criterios de selección (n=3981).Exposición: Consumo de cigarrillo electrónico y/o tabaco sobre la base de preguntas acerca de consumo de tabaco y cigarro electrónico en la vida, categorizándose en solo cigarrillo electrónico, solo tabaco, ambos o ninguno. Variable resultado: Consumo de marihuana en los últimos 12 meses. Resultados: La prevalencia de uso de cigarrillo electrónico y tabaco en la vida fue de 10.1%; de solo cigarrillo electrónico en la vida, de 1.2%, y de consumo de marihuana en los últimos 12 meses, de 5.2%. Aquellos con uso dual tuvieron 40.34 veces la probabilidad de consumir marihuana en los últimos 12 meses (PR 40.34 IC95: 14.76 a 110.25, p <0.001) en comparación con los que no consumieron ninguno. Los que consumieron solo tabaco tuvieron 23 veces la probabilidad de consumir marihuana en los últimos 12 meses (PR 23.12 IC95: 8.43 a 63.35, p <0.001) en comparación con los que no consumieron ninguno. Conclusiones: Se encontró un aumento de probabilidad de consumo de marihuana en los últimos 12 meses en aquellos estudiantes universitarios que reportaron uso de cigarrillo electrónico y tabaco en la vida, así como entre los que reportaron uso exclusivo de tabaco.Background: The electronic cigarettes use has gained populatiry in the last years, and together with tobacco use, they increase the nicotine exposure. Cannabis is the most consumed illicit drug by the young population in Perú. Objective: To identify the association between the use of electronic cigarettes and/or tobacco in life with the cannabis use in the last 12 months. Methods: An analytical cross-sectional study was developed secondary to the III Andean Epidemiological Study on Drug Consumption in University Students, 2016. A multivariate analysis was performed using a generalized linear model of the family and the log Poisson link option. Participants: University students (n=3981).Exposure: Electronic cigarette and/or tobacco consumption based on questions about consumption of tobacco and electronic cigarette in life, being categorized into only electronic cigarette, only tobacco, both or neither.Outcome: Cannabis use in the last 12 months. Results: Of the total number of university students who met the inclusion criteria (n = 3981), the lifetime prevalence of electronic cigarettes and tobacco (dual) use was 10.1% and 1.2% for electronic cigarettes. Cannabis use in the last 12 months was 5.2%. Those with dual use had forty times the probability of using cannabis in the last 12 months (PR 40.34, CI95: 14.76 to 110.25, p <0.001) compared to those who used none, and those who used only tobacco had twenty-three times the probability of using cannabis in the last 12 months (PR 23.12, CI95: 8.43 to 63.35, p <0.001) compared to those who consumed none. Conclusions: An increase in the probability of cannabis use in the last 12 months was found in those university students who reported dual use of electronic cigarettes and tobacco in life, and also in those who reported exclusive use of tobacco. We didn’t find an increased probability of cannabis use in the last 12 months among the electronic cigarettes only users.Tesi

Factors Associated with Drug Consumption Without Scientific Evidence in Patients with Mild COVID-19 in Peru

Objective This study aimed to evaluate the factors associated with the consumption of drugs without scientific evidence in patients with mild COVID-19 infection in Peru. Methods An analytical cross-sectional study was carried out including 372 adult patients with a history of mild COVID-19 disease. Factors associated with drug consumption were evaluated by Poisson regressions with robust variance adjustment using the bootstrapping resampling method. Results Seventy-two percent consumed some medication without scientific evidence, with antibiotics (71%) and ivermectin for human use (68%) being the most commonly used. Factors associated with the consumption of drugs to treat mild COVID-19 infection were thinking that the drugs are not effective (adjusted prevalence ratio, 0.55; 95% confidence interval, 0.41-0.74) and not being informed about the efficacy of the drugs (adjusted prevalence ratio, 0.48; 95% confidence interval, 0.36-0.65). Conclusions Education of the population seems to be the main factor that increases the consumption of drugs without scientific evidence in the Peruvian population to treat mild COVID-19.Revisión por pare

Level of Knowledge Regarding Mpox among Peruvian Physicians during the 2022 Outbreak: A Cross-Sectional Study

Introduction: Due to the high incidence of mpox in Peru and the poor knowledge about this disease among healthcare workers in non-endemic countries, it is crucial to determine the knowledge status of Peruvian physicians. Methodology: We conducted an analytical cross-sectional study based on an online survey from August to September 2022. Physicians who had a medical license and lived and practiced medicine in Peru were included. To evaluate the factors associated with a higher level of knowledge, we used crude (cPR) and adjusted (aPR) prevalence ratios with 95% confidence intervals (95% CI) using Poisson regression. Results: We included 463 physicians. The mean age was 36.6 (SD: 10.3) years, and most were male (58.1%). Regarding knowledge, the median knowledge score was 14 [IQR: 13 to 15] out of 17 points. In terms of knowledge gaps, only 60.7% of the participants knew that there was an FDA-approved vaccine for mpox, 49.0% of participants knew about mpox proctitis and 33.3% acknowledged that it could be transmitted by the bite of an infected rodent. We found that taking care of patients with mpox (aPR: 1.39; 95% CI: 1.13 to 1.72) was associated with higher knowledge (>p50), while living in the eastern macro-region (aPR: 0.62; 95% CI: 0.42 to 0.93) was associated with lower knowledge (≤p50). Conclusions: Our study showed a high level of knowledge about mpox among Peruvian physicians. However, educational campaigns may be necessary, especially for physicians from the eastern region and those who do not have clinical experience with mpox

Nivel de conocimiento sobre Mpox entre médicos peruanos durante el brote de 2022: un estudio transversal

Introduction: Due to the high incidence of mpox in Peru and the poor knowledge about this disease among healthcare workers in non-endemic countries, it is crucial to determine the knowledge status of Peruvian physicians. Methodology: We conducted an analytical cross-sectional study based on an online survey from August to September 2022. Physicians who had a medical license and lived and practiced medicine in Peru were included. To evaluate the factors associated with a higher level of knowledge, we used crude (cPR) and adjusted (aPR) prevalence ratios with 95% confidence intervals (95% CI) using Poisson regression. Results: We included 463 physicians. The mean age was 36.6 (SD: 10.3) years, and most were male (58.1%). Regarding knowledge, the median knowledge score was 14 [IQR: 13 to 15] out of 17 points. In terms of knowledge gaps, only 60.7% of the participants knew that there was an FDA-approved vaccine for mpox, 49.0% of participants knew about mpox proctitis and 33.3% acknowledged that it could be transmitted by the bite of an infected rodent. We found that taking care of patients with mpox (aPR: 1.39; 95% CI: 1.13 to 1.72) was associated with higher knowledge (>p50), while living in the eastern macro-region (aPR: 0.62; 95% CI: 0.42 to 0.93) was associated with lower knowledge (≤p50). Conclusions: Our study showed a high level of knowledge about mpox among Peruvian physicians. However, educational campaigns may be necessary, especially for physicians from the eastern region and those who do not have clinical experience with mpox.Introducción: Debido a la alta incidencia de la mpox en Perú y al escaso conocimiento sobre esta enfermedad entre los trabajadores de la salud en países no endémicos, es crucial determinar el estado de conocimiento de los médicos peruanos. Metodología: Realizamos un estudio transversal analítico basado en una encuesta en línea de agosto a septiembre de 2022. Se incluyeron médicos que tenían licencia médica y residían y ejercían la medicina en Perú. Para evaluar los factores asociados a un mayor nivel de conocimiento se utilizaron razones de prevalencia crudas (cPR) y ajustadas (aPR) con intervalos de confianza del 95% (IC 95%) mediante regresión de Poisson. Resultados: Se incluyeron 463 médicos. La edad media fue de 36,6 (DE: 10,3) años y la mayoría eran hombres (58,1%). En cuanto a los conocimientos, la mediana de la puntuación de conocimientos fue de 14 [RIC: 13 a 15] sobre 17 puntos. En cuanto a las lagunas de conocimiento, solo el 60,7 % de los participantes sabía que existía una vacuna contra la mpox aprobada por la FDA, el 49,0 % de los participantes conocía la proctitis por mpox y el 33,3 % reconocía que podía transmitirse por la picadura de un roedor infectado. Encontramos que cuidar a pacientes con mpox (RPa: 1,39; IC 95%: 1,13 a 1,72) se asoció con un mayor conocimiento (>p50), mientras vivan en la macrorregión oriental (RPa: 0,62; IC 95%: 0,42 a 0,93) se asoció con un menor conocimiento (≤p50). Conclusiones: Nuestro estudio mostró un alto nivel de conocimiento sobre la mpox entre los médicos peruanos. Sin embargo, pueden ser necesarias campañas educativas, especialmente para los médicos de la región oriental y aquellos que no tienen experiencia clínica con la mpox