Características de las Infecciones asociadas a atenciones en la salud y uso de antibióticos en una Unidad de Cuidados Intensivos COVID- 19, del norte peruano: 2020-2021

Objective: To describe the frequency of HAIs and the use of antibiotics in a COVID ICU in northern Peru. Material and Methods: cross-sectional descriptive study. 85 stories were reviewed. Results: median age= 57 years, IQR (49-78); 70% men; 74/85 on a ventilator, median in days= 13 (IQR=7-45). HAI frequency: 28.2%: Ventilator-associated pneumonia 79.1%; 26/85 had at least one culture: 22/26 bronchial secretions: 10/26 Acinetobacter baumani, 10/26 Pseudomonas Aeruginosa; 8/10 of Acinetobacter and 5/10 of Pseudomonas were multidrug resistant; 100% of patients received antibiotics; 63% Carbapenems (36% Imipenem and 27% Meropenem) and 22% third-class cephalosporins (14% Ceftazidime and 8% Ceftriaxone); mortality: 30.6%. Of the 19 VAP, 7/19 were due to Acinetobacter Baummani and 10/19 due to Pseudomonas Aeruginosa. Of the deceased, 19% had Acinetobacter baumani and 11% had Pseudomonas Aeruginosa. Conclusion: the most frequent germs: Acinetobacter and Pseudomona, all patients received antibiotics and the most frequent was imipenem.Objetivo: Describir la frecuencia de IAAS y el uso de antibióticos en una UCI COVID del norte peruano. Material y Métodos: estudio descriptivo trasversal. Se revisaron 85 historias. Resultados: mediana de edad= 57 años, RIC (49- 78); 70 % hombres; 74/85 en ventilador, mediana en días= 13 (RIC=7-45). Frecuencia de IAAS: 28,2%: Neumonía asociada a Ventilador 79,1%; 26/85 tuvo al menos un cultivo: 22/26 secreción bronquial: 10/26 Acinetobacter baumani,10/26 Pseudomona Aeruginosa; 8/10 de Acinetobacter y 5/10 de las Pseudomonas fueron multidrogoresistentes; 100% de pacientes recibieron antibióticos; 63 % Carbapenems (36 % Imipenem y 27 % Meropenem) y 22 % cefalosporinas de tercera (14% Ceftazidime y 8% Ceftriaxona); mortalidad: 30,6%. De 19 NAV, 7/19 fueron por Acinetobacter Baummani y 10/19 por Pseudomona Aeruginosa. De los fallecidos, 19% tuvo Acinetobacter baumani y 11% Pseudomona Aeruginosa. Conclusión: gérmenes más frecuentes: Acinetobacter y Pseudomona, todos los pacientes recibieron antibióticos; el más frecuente fue Imipenem

Sexual behavior, use of contraceptive methods and pregnancy in young people from a population affiliated in a health insurer company in Colombia 2018

Describe the average age of sexual life onset from young people and adolescents, the prevalence of contraceptive methods and explore determinants of pregnancy. A retrospective cohort (2014-2018) was followed by a health insurer of the subsidized regime in Colombia. The study sample consisted of 35,214 young people aged 10-24 years living in 21 municipalities of the Colombian Caribbean region. For the social determinants of pregnancy, a multivariate probit model was estimated using as explanatory variables, housing area, education, family functionality and sexual behavior. 10.3% of women and 14.1% of men had their first sexual encounter before age 14 and 43.5% of women and 37.4% of men began their sex life after age 17. From the young people who claimed to have started their sexual life, 70.9% of the men made use of the condom as a contraceptive method, while the women divided on average 27.2% for the pills and / or injections followed by 16 , 1% in the use of the subdermal implant. As determinants of pregnancy in young people under 20, it was found that variables such as suspending school years [Yes (β = 0.6, p = 0.006)], being planned with hormonal method [Yes (β = 0.5, p = 0.000)] or start sexual life [Between 10 to 14 years (β = 0.14, p = 0.000)], increase the likelihood of young women becoming pregnant at some time in their life. These results also showed that the schooling of the young [University (β = -0.4, p = 0.038)] and always use condoms in sexual intercourse [Yes (β = -0.5, p = 0.042)] help prevent the pregnancy event from occurring. The age of sexual onset establishes a basis on which decision makers should intervene for promote a safe sex life, from use of anticonceptives in young people and thus avoiding unplanned pregnancy

Perception, prevalence and factors associated to school bullying in young people from a population affiliated in a colombian health subsidized insurance company in 2018.

Describe the perception from young people about bullying, the prevalence of this event and explore the factors associated with being a victim. A retrospective cohort (2014-2018) was followed by a health insurer company of the subsidized regime in Colombia. The study sample consisted of 35,214 young people aged 10-24 years living in 21 municipalities of the Colombian Caribbean region. Means and standard deviation were expressed for continuous variables and frequencies for categorical variables. For the associated factors, a logistic model was estimated using as explanatory variables, sex, housing area, age range, family functionality, disability of the young person, disability of a family member and variables of psychological perception. 63.6% of young people answered that they have knowledge about what school bullying is, noting that as the schooling of the young person increases, the higher the proportion of positive response. The physical or verbal school bullying rate was 94 young people per 1,000. It was found that factors such as the youth feeling useless and guilty (OR = 3.14, p = 0.000), attending psychological counseling (OR = 1.78, p = 0.000), repeating years (OR = 1.49, p = 0.000), that the young person has a disability (OR = 1.33, p = 0.004), or a family member has a disability (OR = 1.27, p = 0.000), is associated with being a victim of bullying. Likewise, it was found that belonging to a highly functional family environment (OR = 0.57, p = 0.000) is a protective factor. School bullying is an event that needs attention and requires supervision of all those around young people, in order to avoid changes in behavior or suicide. Therefore, health systems must offer comprehensive care to prevent mental health risks related to bullying given their relationship with the presence of disability of the young person or a relativ

Impact in hospitalization costs of a cardiovascular risk management program in Colombia: a propensity score matching model

Cardiovascular diseases (CVD) are the leading cause of death and burden of disease in Colombia and globally. In 2017, CVD represented the 12% of total DALYs. CVD is a costly disease from patient, family and societal perspectives. Effective prevention and risk management programs reduces the incidence of CVD by as much as 80%. We aimed to estimate the impact of direct medical hospitalization costs related to adherence in a risk management program in Colombia, 2018. We retrospectively collected data from 6,243 patients with data of enrollment in a cardiovascular risk management program (DTC, in Spanish) of a subsidized insurer, who presented arterial hypertension (AH) or AH+ type 2 diabetes mellitus (DM2). 1,065 were identified adherent to the program (treated) and 5.178 non adherent (controls). We designed a propensity score matching model adjusted with confounding variables to estimate the effect of treatment (program adherence) over hospitalization cost. Costs were calculated based on hospitalization invoices and expressed in Colombian pesos (COP) 2018. DTC has an average negative effect on cost of treated population. Being treated avoids hospitalization costs; these results were statistically significant at the 5% and 10% level (with 95%CI that goes through zero). Hence, being in the DTC program reduces hospital costs that ranges from COP-$11,346,372 to -$ 799,259 (95%CI) compared to the average cost. The overall impact on program costs is a significant saving of COP583,670 per event-year. If all members of the DTC program fulfilled its activities by more than 80%, the savings generated by the program would be close to COP$ 6.85 billion. DTC risk management program reduces direct hospitalization costs of events associated to CVD. Our results are important to design policies focused on the cost and risk management of patients with CVD in poor population

SARS-CoV-2 seroprevalence on the north coast of Peru: A cross-sectional study after the first wave

Peru had the second-highest number of COVID-19 cases in Latin America. After the first wave, Peru registered more than 900,000 cases of COVID-19 and more than 36,000 confirmed deaths from the disease. Tumbes, a border area with poor sanitation and not enough water, had the fifth highest death rate. The cross-sectional analytic study aimed: a) to assess seroprevalence of COVID-19 after the first wave; b) to assess sociodemographic determinants and symptoms associated with a positive COVID-19 antibody lateral flow test

SARS-CoV-2 seroprevalence on the north coast of Peru: A cross-sectional study after the first wave

During the first wave, COVID-19 had devastating effects on developing countries like Peru, which reported more than 900,000 cases of the disease and more than 36,000 confirmed deaths from it. The informal settlements are counted in COVID-19 regional statistics, but they are very different from the rest of the region in terms of sanitation, access to water and sewage, housing conditions, and others. To make good decisions about public health, it is important to understand how the disease is spread in informal settlements. We did an observational, cross-sectional study in Puerto Pizarro, a remote port village in Tumbes, from November 11, 2020, to November 30, 2020, to assess the seroprevalence of COVID-19 after the first wave, as well as the sociodemographic factors and symptoms linked to a positive COVID-19 antibody lateral flow test. 1391 people older than 2 years old were given census and symptom questionnaires. They were also tested for the presence of anti-SARS-CoV-2 antibodies (IgG and IgM) in their blood. This study shows an adjusted seroprevalence of 24.82 percent (95% CI 22.49–27.25) posterior to the first wave of COVID-19 in Tumbes. Women had higher adjusted seroprevalence (28.03% vs. 21.11% [95% CI 24.83–31.41], p = 0.002). Extrapolating our adjusted prevalence of 24.82 per 100 persons to Tumbes (N = 251,541), 62,432 people were infected during the first wave, which is too high for adequate primary care in health institutions. Puerto Pizarro’s causespecific mortality rate was 198.49 per 100,000 inhabitants (deaths documented between May and December 2020), which was higher than Tumbes’ up to December 2020 (137.6 per 100,000 inhabitants). The presence of mostly symptomatic patients at health care facilities, the limited use of social networks, the scarce availability of eHealth technologies in government institutions, unused emergency telephone numbers, and the fear of dying if referred to the hospital may have led to underreporting cases. Participation of the community in epidemiological surveillance strategies is critical to assisting the Ministry of Health in the future success of the establishment of an eHealth surveillance monitoring program

Learning curves of basic laparoscopic psychomotor skills in SINERGIA VR simulator

Purpose: Surgical simulators are currently essential within any laparoscopic training program because they provide a low-stakes, reproducible and reliable environment to acquire basic skills. The purpose of this study is to determine the training learning curve based on different metrics corresponding to five tasks included in SINERGIA laparoscopic virtual reality simulator. Methods: Thirty medical students without surgical experience participated in the study. Five tasks of SINERGIA were included: Coordination, Navigation, Navigation and touch, Accurate grasping and Coordinated pulling. Each participant was trained in SINERGIA. This training consisted of eight sessions (R1–R8) of the five mentioned tasks and was carried out in two consecutive days with four sessions per day. A statistical analysis was made, and the results of R1, R4 and R8 were pair-wise compared with Wilcoxon signed-rank test. Significance is considered at P value <0.005. Results: In total, 84.38% of the metrics provided by SINERGIA and included in this study show significant differences when comparing R1 and R8. Metrics are mostly improved in the first session of training (75.00% when R1 and R4 are compared vs. 37.50% when R4 and R8 are compared). In tasks Coordination and Navigation and touch, all metrics are improved. On the other hand, Navigation just improves 60% of the analyzed metrics. Most learning curves show an improvement with better results in the fulfillment of the different tasks. Conclusions: Learning curves of metrics that assess the basic psychomotor laparoscopic skills acquired in SINERGIA virtual reality simulator show a faster learning rate during the first part of the training. Nevertheless, eight repetitions of the tasks are not enough to acquire all psychomotor skills that can be trained in SINERGIA. Therefore, and based on these results together with previous works, SINERGIA could be used as training tool with a properly designed training program

Características clínicas y evolución de la infección por SARS-CoV-2 en pacientes con lupus eritematoso sistémico en Argentina: datos del registro nacional SAR-COVID

Introducción: el lupus eritematoso sistémico (LES) es una enfermedad sistémica que se ha asociado a mayor severidad con la infección por SARS-CoV-2. Particularmente la alta actividad de la enfermedad y algunos inmunosupresores se han vinculado a peores desenlaces. Objetivos: describir las características por SARS-CoV-2 en pacientes con LES en Argentina del registro SAR-COVID y establecer los factores asociados a peor desenlace de la misma. Materiales y métodos: estudio observacional. Se incluyeron pacientes con diagnóstico de LES con infección confirmada por SARS-CoV-2 (RT-PCR y/o serología positiva) del registro SAR-COVID. Los datos se recolectaron desde agosto de 2020 hasta marzo de 2022. El desenlace de la infección se midió mediante la escala ordinal de la Organización Mundial de la Salud (EO-OMS). Se definió COVID-19 severo con un valor EO-OMS ≥5. Análisis descriptivo, test T de Student, U de Mann Whitney U, ANOVA, chi2 y Fisher. Regresión logística múltiple. Resultados: se incluyeron 399 pacientes, el 93% de sexo femenino, con una edad media de 40,9 años (DE 12,2). El 39,6% tenía al menos una comorbilidad. Al momento de la infección, el 54,9% recibía glucocorticoides, el 30,8% inmunosupresores y el 3,3% agentes biológicos. La infección por SARS-CoV-2 fue leve en la mayoría de los casos, mientras que un 4,6% tuvo curso severo y/o falleció. Estos últimos presentaban comorbilidades, usaban glucocorticoides y tenían síndrome antifosfolípido (SAF) con mayor frecuencia y mayor actividad de la enfermedad al momento de la infección. En el análisis multivariado, la hipertensión arterial, el diagnóstico de SAF y el uso de glucocorticoides se asociaron a hospitalización severa y/o muerte por COVID-19 (EO-OMS ≥5). Conclusiones: en esta cohorte de pacientes con LES con infección por SARS-CoV-2 confirmada, la mayoría cursó de manera sintomática, un 22,1% fue hospitalizado y un 5% requirió ventilación mecánica. La mortalidad fue cercana al 3%. El diagnóstico de SAF, tener hipertensión arterial y el uso de glucocorticoides se asociaron significativamente con COVID-19 severo

4to. Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad. Memoria académica

Este volumen acoge la memoria académica de la Cuarta edición del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad, CITIS 2017, desarrollado entre el 29 de noviembre y el 1 de diciembre de 2017 y organizado por la Universidad Politécnica Salesiana (UPS) en su sede de Guayaquil. El Congreso ofreció un espacio para la presentación, difusión e intercambio de importantes investigaciones nacionales e internacionales ante la comunidad universitaria que se dio cita en el encuentro. El uso de herramientas tecnológicas para la gestión de los trabajos de investigación como la plataforma Open Conference Systems y la web de presentación del Congreso http://citis.blog.ups.edu.ec/, hicieron de CITIS 2017 un verdadero referente entre los congresos que se desarrollaron en el país. La preocupación de nuestra Universidad, de presentar espacios que ayuden a generar nuevos y mejores cambios en la dimensión humana y social de nuestro entorno, hace que se persiga en cada edición del evento la presentación de trabajos con calidad creciente en cuanto a su producción científica. Quienes estuvimos al frente de la organización, dejamos plasmado en estas memorias académicas el intenso y prolífico trabajo de los días de realización del Congreso Internacional de Ciencia, Tecnología e Innovación para la Sociedad al alcance de todos y todas

Spatial Relationship Between \u3ci\u3eTaenia Solium\u3c/i\u3e Tapeworm Carriers and Necropsy Cyst Burden in Pigs

Background Taenia solium, a parasite that affects humans and pigs, is the leading cause of preventable epilepsy in the developing world. Geographic hotspots of pigs testing positive for serologic markers of T. solium exposure have been observed surrounding the locations of human tapeworm carriers. This clustered pattern of seropositivity in endemic areas formed the basis for geographically targeted control interventions, which have been effective at reducing transmission. In this study, we further explore the spatial relationship between human tapeworm carriers and infected pigs using necroscopic examination as a quantitative goldstandard diagnostic to detect viable T. solium cyst infection in pigs. Methodology/Principal findings We performed necroscopic examinations on pigs from 7 villages in northern Peru to determine the number of viable T. solium cysts in each pig. Participating humans in the study villages were tested for T. solium tapeworm infection (i.e., taeniasis) with an ELISA coproantigen assay, and the distances from each pig to its nearest human tapeworm carrier were calculated. We assessed the relationship between proximity to a tapeworm carrier and the prevalence of light, moderate, and heavy cyst burden in pigs. The prevalence of pig infection was greatest within 50 meters of a tapeworm carrier and decreased monotonically as distance increased. Pigs living less than 50 meters from a human tapeworm carrier were 4.6 times more likely to be infected with at least one cyst than more distant pigs. Heavier cyst burdens, however, were not more strongly associated with proximity to tapeworm carriers than light cyst burdens. Conclusion/Significance Our study shows that human tapeworm carriers and pigs with viable T. solium cyst infection are geographically correlated in endemic areas. This finding supports control strategies that treat humans and pigs based on their proximity to other infected individuals. We did not, however, find sufficient evidence that heavier cyst burdens in pigs would serve as improved targets for geographically focused control interventions