Eficacia y seguridad en condiciones clínicas reales del raltegravir en un hospital de referencia del seguro social peruano

Introduction: Rategravir belongs to integrase inhibitors, being demonstrated and approved by several clinical trials as a powerful and safe antiretroviral drug for the treatment of patients infected with human immunodeficiency virus (HIV), with good tolerance and low toxicity, including in the third line or rescue scheme and it starts when the first and second lineas schemes have failed.Objective: To evaluate the efficacy and safety in real clinical conditions of the use of Raltegravir within the HAART schemes in patients with HIV infection in a reference hospital of social insurance in Peru.Methods: A retrospective observational study was performed in patients with a diagnosis of HIV infection who started treatment within the TARGA scheme based on Raltegravir with follow-up and control at 6 months. We presented summary measures of frequencies and percentages for the qualitative variables, as well as means and standard deviation for the quantitative variables based on the results of the normality tests. The data was processed and analyzed in the statistical software SPSS version 22.Results: The male gender was the most affected with 76% (n = 119) of the total. The most frequent age range was between 45 to 55 years (25.4%, n = 40). The most frequent comorbidities were Diabetes mellitus and arterial hypertension, with exponential reduction in viral load and elevation of CD4 lymphocyte levels.Conclusion: Raltegravir is effective for the treatment of HIV patients.Introducción: El Rategravir pertenece a los inhibidores de integrasas, quedando demostrado y aprobado por diversos ensayos clínicos como un potente antirretroviral seguro y eficaz para el tratamiento de pacientes infectados con el virus de inmunodeficiencia humana (VIH), con buena tolerancia y baja toxicidad, incluyéndose en el esquema de tercera línea o rescate y se inicia cuando los esquemas de primera y segunda línea han fracasado.Objetivo: Evaluar la eficacia y seguridad en condiciones clínicas reales del uso de Raltegravir dentro de los esquemas de la Terapia Antiretroviral de Gran Actividad (TARGA) en pacientes con infección por VIH en un hospital de referencia del seguro social en Perú.Métodos: Se realizó un estudio observacional retrospectivo en pacientes con diagnóstico de infección por VIH que iniciaron tratamiento dentro del esquema TARGA basados en Raltegravir con seguimiento y control a los 6 meses. Se presentaron medidas de resumen de frecuencias y porcentajes para las variables cualitativas, así como medias y desviación estándar para las variables cuantitativas en base a los resultados de las pruebas de normalidad. Los datos fueron procesados y analizados en el software estadístico SPSS versión 22.Resultados: El género masculino fue el más afectado con un 76%(n=119) del total. El rango de edad más frecuente fue el comprendido entre los 45 a 55 años (25,4%; n=40). Las comorbilidades más frecuentes fueron Diabetes mellitus e Hipertensión arterial, con reducción exponencial de la carga viral y elevación de los niveles de linfocitos CD4.Conclusión: El Raltegravir es eficaz para el tratamiento de pacientes VIH

The Latin American Consortium of Studies in Obesity (LASO)

Current, high-quality data are needed to evaluate the health impact of the epidemic of obesity in Latin America. The Latin American Consortium of Studies of Obesity (LASO) has been established, with the objectives of (i) Accurately estimating the prevalence of obesity and its distribution by sociodemographic characteristics; (ii) Identifying ethnic, socioeconomic and behavioural determinants of obesity; (iii) Estimating the association between various anthropometric indicators or obesity and major cardiovascular risk factors and (iv) Quantifying the validity of standard definitions of the various indexes of obesity in Latin American population. To achieve these objectives, LASO makes use of individual data from existing studies. To date, the LASO consortium includes data from 11 studies from eight countries (Argentina, Chile, Colombia, Costa Rica, Dominican Republic, Peru, Puerto Rico and Venezuela), including a total of 32 462 subjects. This article describes the overall organization of LASO, the individual studies involved and the overall strategy for data analysis. LASO will foster the development of collaborative obesity research among Latin American investigators. More important, results from LASO will be instrumental to inform health policies aiming to curtail the epidemic of obesity in the region

Discovery of a Metal-Poor Field Giant with a Globular Cluster Second-Generation Abundance Pattern

We report on the detection, from observations obtained with the Apache Point Observatory Galactic Evolution Experiment spectroscopic survey, of a metal-poor ([Fe/H] = −1.3 dex) field giant star with an extreme Mg–Al abundance ratio ([Mg/Fe] = −0.31 dex; [Al/Fe] = 1.49 dex). Such low Mg/Al ratios are seen only among the second-generation population of globular clusters (GCs) and are not present among Galactic disk field stars. The light-element abundances of this star, 2M16011638-1201525, suggest that it could have been born in a GC. We explore several origin scenarios, studying the orbit of the star in particular to check the probability of its being kinematically related to known GCs. We performed simple orbital integrations assuming the estimated distance of 2M16011638-1201525 and the available six-dimensional phase-space coordinates of 63 GCs, looking for close encounters in the past with a minimum distance approach within the tidal radius of each cluster. We found a very low probability that 2M16011638-1201525 was ejected from most GCs; however, we note that the best progenitor candidate to host this star is GC ω Centauri (NGC 5139). Our dynamical investigation demonstrates that 2M16011638-1201525 reaches a distance $| {Z}_{\max }| \lt 3\,\mathrm{kpc}$ from the Galactic plane and minimum and maximum approaches to the Galactic center of R min < 0.62 kpc and R max < 7.26 kpc in an eccentric (e ~ 0.53) and retrograde orbit. Since the extreme chemical anomaly of 2M16011638-1201525 has also been observed in halo field stars, this object could also be considered a halo contaminant, likely to have been ejected into the Milky Way disk from the halo. We conclude that 2M16011638-20152 is also kinematically consistent with the disk but chemically consistent with halo field stars

USANDO MENTIMETER EN EDUCACIÓN SUPERIOR: HERRAMIENTA DIGITAL EN LÍNEA PARA INCENTIVAR Y POTENCIAR LA ADQUISICIÓN DE CONOCIMIENTO DE MANERA LÚDICA

With the emergence of COVID-19, the educational community has needed to incorporate new methodological approaches to face the new forms of teaching required by the pandemic scenario. One of these approaches is gamification, which implies introducing educational content in a playful way. In Higher Education, gamification must have a level of complexity that the most popular programs can't provide. Mentimeter is a program that is based on an online audience software and allows a wide range of questions and questionnaires significantly suitable for the educational level analysed. It facilitates the active learning of students, increasing their attention, commitment and motivation, thus allowing the student to be the centre of the teaching-learning process. This article analyses the use of Mentimeter in a wide range of classes of various university disciplines and reviews its theoretical and practical potential for the improvement of teaching-learning processes, the acquisition of knowledge by students and the use of new teaching methodologies.Con la irrupción de la COVID-19, la comunidad educativa necesitado incorporar nuevos enfoques metodológicos para enfrentarse a las formas de docencia que ha requerido el escenario de pandemia. Uno de estos enfoques es la gamificación (introducir contenidos educativos de manera lúdica). En la Educación Superior, la gamificación ha de tener un nivel de complejidad que los programas más conocidos no tienen. Mentimeter es un programa que parte de un software de audiencia en línea y permite elaborar preguntas y cuestionarios muy adecuados para los niveles de educación analizados. Facilita el aprendizaje activo del alumnado, aumentando su atención, compromiso y motivación, permitiendo con ello que el/la estudiante sea el centro del proceso de enseñanza-aprendizaje. El presente artículo analiza el uso de Mentimeter en un conjunto amplio de clases de diversas disciplinas universitarias y revisa su potencialidad teórico-práctica para la mejora de los procesos de enseñanza-aprendizaje, la adquisición de conocimiento por parte del alumnado y el uso de nuevas metodologías docentes.Com o surgimento do COVID-19, a comunidade educacional precisou incorporar novas abordagens metodológicas para enfrentar as formas de ensino que o cenário pandêmico tem exigido. Uma dessas abordagens é a gamificação (introdução de conteúdo educacional de forma lúdica). No Ensino Superior, a gamificação deve ter um nível de complexidade que os programas mais populares não possuem. O Mentimeter é um programa que parte de um software de audiência online e permite a elaboração de questões e questionários muito adequados aos níveis de ensino analisados. Facilita a aprendizagem ativa dos alunos, aumentando sua atenção, comprometimento e motivação, permitindo assim que o aluno seja o centro do processo ensino-aprendizagem. Este artigo analisa a utilização do Mentimeter em um amplo conjunto de turmas de diversas disciplinas universitárias e revisa seu potencial teórico-prático para a melhoria dos processos de ensino-aprendizagem, a aquisição de conhecimentos pelos alunos e a utilização de novas metodologias docentes

Incentivar y potenciar la generación colectiva de conocimiento y la participación del alumnado a través de herramientas digitales en línea

El surgimiento de herramientas en línea para la participación del alumnado constituye un recurso con enorme potencial de innovación para la docencia y los procesos de enseñanza y aprendizaje en la educación superior. Por un lado, porque aumenta las posibilidades de generar conocimiento de forma colectiva a través de la colaboración del alumnado con los y las docentes, no solo preguntando y respondiendo de forma anónima (si se quiere que así sea) a las cuestiones que puedan ir planteándose a lo largo del curso, sino también evaluando el propio desarrollo del mismo y las metodologías empleadas. Herramientas que posibilitan esta línea, mediante la llamada gamificación, tan motivante; y metodología de trabajo, como Kahoot o Mentimeter, presentan además una interfaz atractiva y muy fácil de utilizar, tanto por parte del alumnado como del profesorado, a través de cualqiuier dispositivo móvil con posibilidad de conexión a Internet. No obstante, la primera (Kahoot) es mucho más limitada en sus posibilidades que la segunda (Mentimeter). Por este motivo, en este Proyecto de Innovación Docente apostamos por utilizar Mentimeter Estos instrumentos en línea se adaptan de forma muy sencilla tanto a la docencia presencial y sincrónica, como a la docencia semipresencial o en línea (con una cierta asincronicidad), por lo que aparecen como un recurso muy útil en el contexto de incertidumbre respecto a la articulación de la metodología de enseñanza debido a la pandemia de la covid-19. Este proyecto congrega a un grupo de docentes interdisciplinar, interdepartemental, interfacultativo que incluye, además, la participación de un docente experto en la herramienta de otra universidad (URJC).

Somos diversidad. Actividades para la formación de profesionales de la educación formal y no formal en diversidad sexual, familiar, corporal y de expresión e identidad de género

Este manual se presenta como una “caja de herramientas” donde acudir en busca de recursos y actividades didácticas para elaborar formaciones en diversidad sexual, familiar, corporal y de expresión e identidad de género, dirigidas a profesionales que trabajan con jóvenes. En este sentido, son materiales que se pueden adaptar a las necesidades de cada formación y a distintos niveles de conocimiento, tanto de los grupos participantes, como de la persona que dinamice las actividades y que son lo suficientemente flexibles para que puedan ser moldeados y utilizados según los recursos temporales y espaciales que presente cada propuestaformativa. “Somos diversidad” ofrece un total de 44 actividades articuladas en 5 módulos temáticos. Abrazar la diversidad como una oportunidad educativa Transformarse para transformar: afectividad, diferencia y diversidad Sexualidades Corporalidades, identidades y expresiones de género Diversidad familiar Cada módulo ofrece un índice inicial, una breve bienvenida donde se reflejan la justificación y objetivos del módulo, una serie de actividades y un apartado de bibliografía citada y consultada. En cada actividad se detalla su duración estimada, los objetivos propuestos, los recursos necesarios, las indicaciones para su desarrollo, y se aportan finalmente los materiales específicos necesarios para realizarlas. Este manual es el resultado de la actividad “Juventud y LGTBI+: abrazar la diversidad en la educación no formal y formal” dentro del Plan de Actividades Transnacionales (TCA) del programa Erasmus+: Juventud en Acción, organizada por el Injuve y el Grupo de Investigación “Antropología, Diversidad y Convivencia” de la Universidad Complutense de Madrid

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries1,2. However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world3 and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health4,5. However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol—which is a marker of cardiovascular risk—changed from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million–4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world

Diminishing benefits of urban living for children and adolescents’ growth and development

Optimal growth and development in childhood and adolescence is crucial for lifelong health and well-being1–6. Here we used data from 2,325 population-based studies, with measurements of height and weight from 71 million participants, to report the height and body-mass index (BMI) of children and adolescents aged 5–19 years on the basis of rural and urban place of residence in 200 countries and territories from 1990 to 2020. In 1990, children and adolescents residing in cities were taller than their rural counterparts in all but a few high-income&nbsp;countries. By 2020, the urban height advantage became smaller in most countries, and in many high-income western countries it reversed into a small urban-based disadvantage. The exception was for boys in most countries in sub-Saharan Africa and in some countries in Oceania, south Asia and the region of central Asia, Middle East and north Africa. In these countries, successive cohorts of boys from rural places either did not gain height or possibly became shorter, and hence fell further behind their urban peers. The difference between the age-standardized mean BMI of children in urban and rural areas was &lt;1.1 kg m–2 in the vast majority of&nbsp;countries. Within this small range, BMI increased slightly more in cities than in rural areas, except in south Asia, sub-Saharan Africa and some countries in central and eastern Europe. Our results show that in much of the world, the growth and developmental advantages of living in cities have diminished in the twenty-first century, whereas in much of sub-Saharan Africa they have amplified

Repositioning of the global epicentre of non-optimal cholesterol

High blood cholesterol is typically considered a feature of wealthy western countries(1,2). However, dietary and behavioural determinants of blood cholesterol are changing rapidly throughout the world(3) and countries are using lipid-lowering medications at varying rates. These changes can have distinct effects on the levels of high-density lipoprotein (HDL) cholesterol and non-HDL cholesterol, which have different effects on human health(4,5). However, the trends of HDL and non-HDL cholesterol levels over time have not been previously reported in a global analysis. Here we pooled 1,127 population-based studies that measured blood lipids in 102.6 million individuals aged 18 years and older to estimate trends from 1980 to 2018 in mean total, non-HDL and HDL cholesterol levels for 200 countries. Globally, there was little change in total or non-HDL cholesterol from 1980 to 2018. This was a net effect of increases in low- and middle-income countries, especially in east and southeast Asia, and decreases in high-income western countries, especially those in northwestern Europe, and in central and eastern Europe. As a result, countries with the highest level of non-HDL cholesterol-which is a marker of cardiovascular riskchanged from those in western Europe such as Belgium, Finland, Greenland, Iceland, Norway, Sweden, Switzerland and Malta in 1980 to those in Asia and the Pacific, such as Tokelau, Malaysia, The Philippines and Thailand. In 2017, high non-HDL cholesterol was responsible for an estimated 3.9 million (95% credible interval 3.7 million-4.2 million) worldwide deaths, half of which occurred in east, southeast and south Asia. The global repositioning of lipid-related risk, with non-optimal cholesterol shifting from a distinct feature of high-income countries in northwestern Europe, north America and Australasia to one that affects countries in east and southeast Asia and Oceania should motivate the use of population-based policies and personal interventions to improve nutrition and enhance access to treatment throughout the world.Peer reviewe

Height and body-mass index trajectories of school-aged children and adolescents from 1985 to 2019 in 200 countries and territories: a pooled analysis of 2181 population-based studies with 65 million participants

Summary Background Comparable global data on health and nutrition of school-aged children and adolescents are scarce. We aimed to estimate age trajectories and time trends in mean height and mean body-mass index (BMI), which measures weight gain beyond what is expected from height gain, for school-aged children and adolescents. Methods For this pooled analysis, we used a database of cardiometabolic risk factors collated by the Non-Communicable Disease Risk Factor Collaboration. We applied a Bayesian hierarchical model to estimate trends from 1985 to 2019 in mean height and mean BMI in 1-year age groups for ages 5–19 years. The model allowed for non-linear changes over time in mean height and mean BMI and for non-linear changes with age of children and adolescents, including periods of rapid growth during adolescence. Findings We pooled data from 2181 population-based studies, with measurements of height and weight in 65 million participants in 200 countries and territories. In 2019, we estimated a difference of 20 cm or higher in mean height of 19-year-old adolescents between countries with the tallest populations (the Netherlands, Montenegro, Estonia, and Bosnia and Herzegovina for boys; and the Netherlands, Montenegro, Denmark, and Iceland for girls) and those with the shortest populations (Timor-Leste, Laos, Solomon Islands, and Papua New Guinea for boys; and Guatemala, Bangladesh, Nepal, and Timor-Leste for girls). In the same year, the difference between the highest mean BMI (in Pacific island countries, Kuwait, Bahrain, The Bahamas, Chile, the USA, and New Zealand for both boys and girls and in South Africa for girls) and lowest mean BMI (in India, Bangladesh, Timor-Leste, Ethiopia, and Chad for boys and girls; and in Japan and Romania for girls) was approximately 9–10 kg/m2. In some countries, children aged 5 years started with healthier height or BMI than the global median and, in some cases, as healthy as the best performing countries, but they became progressively less healthy compared with their comparators as they grew older by not growing as tall (eg, boys in Austria and Barbados, and girls in Belgium and Puerto Rico) or gaining too much weight for their height (eg, girls and boys in Kuwait, Bahrain, Fiji, Jamaica, and Mexico; and girls in South Africa and New Zealand). In other countries, growing children overtook the height of their comparators (eg, Latvia, Czech Republic, Morocco, and Iran) or curbed their weight gain (eg, Italy, France, and Croatia) in late childhood and adolescence. When changes in both height and BMI were considered, girls in South Korea, Vietnam, Saudi Arabia, Turkey, and some central Asian countries (eg, Armenia and Azerbaijan), and boys in central and western Europe (eg, Portugal, Denmark, Poland, and Montenegro) had the healthiest changes in anthropometric status over the past 3·5 decades because, compared with children and adolescents in other countries, they had a much larger gain in height than they did in BMI. The unhealthiest changes—gaining too little height, too much weight for their height compared with children in other countries, or both—occurred in many countries in sub-Saharan Africa, New Zealand, and the USA for boys and girls; in Malaysia and some Pacific island nations for boys; and in Mexico for girls. Interpretation The height and BMI trajectories over age and time of school-aged children and adolescents are highly variable across countries, which indicates heterogeneous nutritional quality and lifelong health advantages and risks