Presepsin: a new marker of catheter related blood stream infections in pediatric patients

El texto completo de este trabajo no está disponible en el Repositorio Académico UPC por restricciones de la casa editorial donde ha sido publicado.Revisión por pare

Spatial distribution, determinants and trends of full vaccination coverage in children aged 12-59 months in Peru: A subanalysis of the Peruvian Demographic and Health Survey

Objective To assess the spatial distribution, trends and determinants of crude full vaccination coverage (FVC) in children aged 12-59 months between 2010 and 2019 in Peru. Design, setting and analysis A cross-sectional study based on the secondary data analysis of the 2010 and 2019 Peruvian Demographic and Health Surveys (DHSs) was conducted. Logit based multivariate decomposition analysis was employed to identify factors contributing to differences in FVC between 2010 and 2019. The spatial distribution of FVC in 2019 was evaluated through spatial autocorrelation (Global Moran's I), ordinary kriging interpolation (Gaussian process regression) and Bernoulli-based purely spatial scan statistic. Outcome measure FVC, as crude coverage, was defined as having completely received BCG; three doses of diphtheria, pertussis, and tetanus, and polio vaccines; and measles vaccine by 12 months of age. Participants A total of 5 751 and 14 144 children aged 12-59 months from 2010 and 2019 DHSs, respectively, were included. Results FVC increased from 53.62% (95% CI 51.75% to 55.49%) in 2010 to 75.86% (95% CI 74.84% to 76.85%) in 2019. Most of the increase (70.39%) was attributable to differences in coefficients effects. Family size, visit of health workers in the last 12 months, age of the mother at first delivery, place of delivery and antenatal care follow-up were all significantly associated with the increase. The trend of FVC was non-linear and increased by 2.22% annually between 2010 and 2019. FVC distribution was heterogeneous at intradepartmental and interdepartmental level. Seven high-risk clusters of incomplete coverage were identified. Conclusions Although FVC has increased in Peru, it still remains below the recommended threshold. The increase of FVC was mainly attributed to the change in the effects of the characteristics of the population. There was high heterogeneity across Peruvian regions with the presence of high-risk clusters. Interventions must be redirected to reduce these geographical disparities.Revisión por pare

Cultural adaptation and validation of SATAQ-4 “Sociocultural attitudes towards appearance questionnaire-4” for peruvian population

Introduction: Eating disorders (anorexia and bulimia) have been increasing worldwide and nationally. Prior to the development of this disorder, adolescents' present body dissatisfaction, whose study through the ¨Tripartite Influence Model¨ gives us three main pressures: Pressure from parents, media and peers. Factors that are studied through SATAQ-4. We conduct a study to validate the Peruvian version of SATAQ-4 "Sociocultural Attitudes Toward Appearance Questionnaire-4". Methods: A cross-sectional study was carried out in 2015. It was started by culturally adapting the test. Subsequently, validity was determined through the validity of the construct, and reliability through internal consistency assessment and intra-observer reliability (test-retest). Results: We obtained a culturally adapted instrument which presented a mean greater than 3 in the Delphi method, an intraclass correlation equal to 0.83 and an internal consistency (Cronbach alpha) of 0.90. The confirmatory factor analysis supported the original five-factor structure and the convergent validity analysis (r Pearson) when compared with BSQ a correlation of 0.70. Conclusions: The instrument adequately measures the construct for which it was created and can be applied in the Peruvian university environment.National Institutes of HealthRevisión por pare

Fruits and vegetables consumption and depressive symptoms: A population-based study in Peru.

OBJECTIVES: Among different factors, diet patterns seem to be related to depression. The aim of this study was to evaluate the association between the consumption of fruits and/or vegetables and depressive symptoms. METHODOLOGY/PRINCIPAL FINDINGS: A secondary data analysis was conducted using information from a population-based survey from 25 regions from Peru. The outcome was the presence of depressive symptoms according to the Patient Health Questionnaire (cutoff ≥15 to define major depressive syndrome); whereas the exposure was the self-reported consumption of fruits and/or vegetables (in tertiles and using WHO recommendation ≥5 servings/day). The association of interest was evaluated using Poisson regression models controlling for the complex-sample survey design and potential confounders. Data from 25,901 participants were analyzed, mean age 44.2 (SD: 17.7) and 13,944 (54.0%) women. Only 910 (3.8%; 95%CI: 3.5%-4.2%) individuals reported consuming ≥5 servings of fruits and/or vegetables/day; whereas 819 (2.8%; 95%CI: 2.5%-3.1%) had depressive symptoms. Those in the lowest tertile of fruits and/or vegetables consumption had greater prevalence of depressive symptoms (PR = 1.88; 95%CI: 1.39-2.55) than those in the highest tertile. This association was stronger with fruits (PR = 1.92; 95%CI: 1.46-2.53) than vegetables (PR = 1.42; 95%CI: 1.05-1.93) alone. CONCLUSIONS: An inverse relationship between consumption of fruits and/or vegetables and depressive symptoms is reported. Less than 5% of subjects reported consuming the amount of fruits and vegetables recommended by the WHO. There is a need to implement strategies to promote better diet patterns with potential impact on mental health

The short-form of the Cyberchondria Severity Scale (CSS-12): Adaptation and validation of the Spanish version in young Peruvian students

BACKGROUND: Cyberchondria is defined as the increase in health-related anxiety or anguish associated with excessive or repeated online searches for health-related information. Our objective was to cross-culturally adapt and validate the CSS-12 scale for Peruvian Spanish speakers, to determine whether the Bifactor model works as well in our population as in previous studies' and to explore whether the Bifactor-ESEM is a more suitable model. METHODS: We performed a cultural adaptation using the Delphi method and a validation study on medical students between 2018 and 2019. Reliability was evaluated by using Cronbach's alpha (α) and McDonald's omega (Ω) for internal consistency, and Pearson's r and intraclass correlation coefficient (ICC), for test-retest reliability. We evaluated construct validity by contrasting four measurement models for the CSS-12 and the convergent validity against health anxiety. RESULTS: The Spanish CSS-12 showed excellent reliability (α = .93; Ω = .93; ICC = .93; r = .96). The Bifactor ESEM model showed the best fit, supporting a unidimensional measure of the general cyberchondria. This measure was positively associated with health anxiety (r = .51). CONCLUSIONS: The Spanish CSS-12 provides a valid and reliable unidimensional measure of cyberchondria, which is distinguishable from the more general health anxiety. This can be applied to similar populations and future research. The Bifactor-ESEM model appears to offer a more accurate and realistic representation of the multifaceted nature of cyberchondria. We provide a free-to-use form of the Spanish CSS-12 as supplemental material

Asociation between nutritional status and depressive symptoms in a Peruvian adult population: A population-based study in Peru

Introduction. Among the Peruvian population, the prevalence of overweight and obesity has increased, making it one of the main public health problems. There is also conflicting evidence on the association between increased BMI and depressive symptoms in the adult population. Objective. To determine the association between nutritional status (NS) and depressive symptoms (DS) in the Peruvian population. Method. We conducted a secondary data analysis of the Peruvian Demographic and Family Health Survey (ENDES). We assessed the NS according to body mass index (BMI), grouped into normal weight (BMI = 18.50 - 24.99), overweight (BMI = 25.00 - 29.99), 1A obesity (BMI = 30.00 - 32.49), and 1B obesity (BMI ≥ 32.50). DS were assessed using the Patient Health Questionnaire (PHQ-9) instrument. A generalized linear model stratified by sex was constructed to calculate crude (cPRc) and adjusted (aPR) prevalence ratios. Results. A total of 26,463 records of people aged 18-60 years were assessed, yielding a 6.3% prevalence of DS (≥ 10 points). Females had a higher frequency of DS than males, which increased depending on their NS: normal weight 7.8%, overweight 8.2%, 1A obesity 9.0%, and 1B obesity 12.0%. Likewise, in the multivariate analysis, women with 1B obesity reported a higher frequency of DS (aPR = 1.30; 95% CI = [1.03, 1.63]). Discussion and conclusion. There is a strong association between nutritional status and depressive symptoms in Peruvian women, with obese women being more likely to have depressive symptoms.Revisión por pare

Estudios transversales: Cross-sectional studies

Cross-sectional studies are epidemiological design which can be considered as descriptive or analytical designs depending on the general objective. This is a quickly and economical design and allows to calculate the prevalence of a condition. Also, the relationship of temporality between the exposition and the outcome is being measured simultaneously on a unique period, not being possible to identify a directionality in the temporality. When there is an analytic objective, the association measure used is the Prevalence Ratio (PR), specially when the prevalence of the outcome is more or equal to 10% or the Odds Ratio (OR) when that prevalence is lower. To quantify this association different regression models like Binomial log or Poisson log can be used, including generalized lineal models. If the association measure is OR, the most common used model is the multiple logistic regression.Los estudios observacionales transversales pueden ser de tipo descriptivos o también analíticos dependiendo del objetivo general. Este diseño es rápido, económico y permite el cálculo directo de la prevalencia de una condición. Además, la relación de temporalidad entre la exposición y el efecto son medidas de forma simultánea en un único período, no siendo posible identificar una direccionalidad en la temporalidad. Cuando estos estudios persiguen un objetivo general analítico, la medida de asociación es la Razón de Prevalencias (RP), especialmente cuando la prevalencia del efecto es mayor o igual a 10% o el Odds Ratio (OR) cuando la prevalencia es baja. Para cuantificar esta asociación pueden utilizarse diferentes modelos de regresión como el binomial log o Poisson log, incluyendo los modelos lineales generalizados. Cuando la medida de asociación a utilizar es el OR, el modelo más comúnmente empleado es la regresión logística múltiple.&nbsp

Patrones de resistencia antimicrobiana de la familia enterobacteriaceae aisladas de infecciones del tracto urinario de una región alto-andina peruana

Background: Antibiotic resistance is considered to be the next worldwide epidemic. Urinary tract infections (UTI) are the second most common cause of infection, which also has the highest resistance frequency. Nevertheless, in high Andean regions, little is known about the antibiotic resistance. Objectives : Determine the antimicrobial resistance patterns of the enterobacteriaceae family isolated from urinary tract infections of a Peruvian Andean region. Material and Methods: A retrospective cross-sectional review of 1717 records from the microbiology service of a private health institution from Puno - Peru, was done between the years 2014 and 2017. Antibiotic resistance by uropathogens was studied among different age groups. Statistical analysis included Chi2 test with a p<0.05. Poisson regression was used to calculate the prevalence ratio (PR) with a 95% confidence interval. Findings: There was a wide distribution of antibiotic resistance among all the antibiotics, mainly in Escherichia coli and Proteus spp. The elderly had the highest prevalence of antibiotic resistance. As age increased, resistance to all drugs also increased (p<0.01). Furthermore, the elderly had a risk probability of resistance of 1.22, 1.42, 1.20 and 1.32 to penicillins, cephalosporins, quinolones and other antibiotics respectively. Conclusion: The antimicrobial resistance patterns of the Peruvian Andean region were lower than national and international patterns.Introducción: La resistencia a antibióticos es considerada la próxima epidemia mundial. Las infecciones del tracto urinario (ITU) son la segunda causa más común de infecciones y la que presenta mayor frecuencia de resistencia. Sin embargo, poco se ha reportado en regiones altos-andinas. Objetivo: Evaluar los patrones de resistencia antimicrobiana de la familia enterobacteriaceae aisladas de infecciones del tracto urinario de pacientes ambulatorios de una región altoandina peruana y sus factores asociados. Material y Métodos: Estudio transversal analítico retrospectivo, a partir de 1717 registros del Servicio de Microbiología de una institución de salud en la región Puno - Perú, entre los años 2014 al 2017. Se estudió la resistencia a antibióticos según uropatógeno en diferentes grupos etarios. Se empleó la prueba de Chi2 de Pearson y un modelo de regresión de de Poisson para calcular la razón de prevalencias (RP). En todos los análisis se consideró un valor de p<0.05 como significativo y se estimaron intervalos de confianza al 95%. Resultados: Se presentó una amplia distribución de resistencia en todos los fármacos evaluados, siendo mayor en Escherichia coli y Proteus spp. El grupo etario, ≥ 60 años, presentó la mayor prevalencia de resistencia bacteriana. A medida que la edad aumentaba, la resistencia a todos los fármacos estudiados también aumentó (p <0.01). Así mismo, los pacientes ≥ 60 años presentaron mayor probabilidad de presentar resistencia bacteriana a penicilinas, cefalosporinas y quinolonas. Conclusión: El patrón de resistencia a los antibióticos utilizados en ITUs en la zona altoandina peruana incrementa con la edad

Distribución de casos auto-reportados de tuberculosis pulmonar activa en seis centros penitenciarios de Lima, Perú: Un Subanálisis del Censo Nacional de Población Penitenciaria

Introducción: La tuberculosis pulmonar (TBP) sigue siendo considerada una de las enfermedades infecciosas, afectando especialmente a las personas privadas de su libertad (PPL). Por lo tanto, este estudio tuvo como objetivo determinar la distribución de casos auto-reportados de TBP en seis Centros Penitenciarios (CP) peruanos según nivel de hacinamiento. El estudio: Se realizó un estudio observacional, transversal y descriptivo de la base de datos del Primer Censo Nacional Penitenciario del 2016. Se incluyó PPL de los 6 CP del departamento de Lima, los cuales cuentan con la mayor prevalencia de tuberculosis intrapenitenciaria a nivel nacional. Hallazgos: Se calculó la prevalencia según nivel de hacinamiento tanto bajo, medio y alto, siendo su valor: 4 834, 3 902 y 3 039/100 000 habitantes, respectivamente. Conclusiones: La distribución de TBP fue predominantemente homogénea en los CP, independientemente del nivel de hacinamiento. Los casos auto-reportados de TBP activa estaban presentes en la totalidad de los CP. Introducción: La tuberculosis pulmonar (TBP) sigue siendo considerada una de las enfermedades infecciosas, afectando especialmente a las personas privadas de su libertad (PPL). Por lo tanto, este estudio tuvo como objetivo determinar la distribución de casos auto-reportados de TBP en seis Centros Penitenciarios (CP) peruanos según nivel de hacinamiento. El estudio: Se realizó un estudio observacional, transversal y descriptivo de la base de datos del Primer Censo Nacional Penitenciario del 2016. Se incluyó PPL de los 6 CP del departamento de Lima, los cuales cuentan con la mayor prevalencia de tuberculosis intrapenitenciaria a nivel nacional. Hallazgos: Se calculó la prevalencia según nivel de hacinamiento tanto bajo, medio y alto, siendo su valor: 4 834, 3 902 y 3 039/100 000 habitantes, respectivamente. Conclusiones: La distribución de TBP fue predominantemente homogénea en los CP, independientemente del nivel de hacinamiento. Los casos auto-reportados de TBP activa estaban presentes en la totalidad de los CP.

El Ensayo Clínico Aleatorizado de Plasma Convaleciente en EsSalud

Letter to the Editor (without abstract)Carta al Editor (sin resumen