Asociación entre depresión-ansiedad y el síndrome de fibromialgia en 3 centros asistenciales del distrito de Chiclayo

Objetivo: determinar la asociación entre depresión y ansiedad con el síndrome de fibromialgia en los pacientes atendidos por consulta externa de tres centros asistenciales del distrito de Chiclayo. Material y métodos: estudio analítico de tipo casos y controles prospectivo en el que los pacientes provenientes de los consultorios de medicina interna y reumatología de 3 centros asistenciales, fueron evaluados mediante entrevista estructurada para datos clínicos y epidemiológicos y mediante los test de Zung para depresión y ansiedad. Se usó estadística descriptiva, frecuencias absolutas y relativas, se midieron los ODDS ratio para depresión y ansiedad y los intervalos de confianza, con un nivel de significancia de 0,05; se utilizó el programa estadístico Epidat 3.1 y SPSS v17. Resultados: de 208 pacientes en total, 52 (25%) fueron casos y 156 (75%) controles. Hubo mayor frecuencia de síndrome de fibromialgia en las mujeres 48(92%); la mayoría de pacientes con fibromialgia tuvieron algún grado de depresión y ansiedad: 50(96,2) y 48(92,3%) respectivamente, la depresión fue en mayor medida de tipo severa 20(38,4%) y el nivel de ansiedad más frecuente fue el tipo mínimo-moderada 26(50%). Se halló asociación entre síndrome de fibromialgia y ansiedad (Odds ratio: 9,7 IC: 3,1-29,5 p:0,05). Conclusión: la frecuencia de ansiedad y depresión en pacientes con síndrome de fibromialgia fue elevada. Sólo se halló asociación entre ésta y la ansiedad.Tesi

Asociación entre Depresión-Ansiedad y el Síndrome de Fibromialgia en 3 centros asistenciales de Lambayeque, Perú, 2011 -2012

Objetivo: determinar la asociación entre depresión y ansiedad con el Síndrome de Fibromialgia en los pacientes atendidos por consulta externa de tres centros asistenciales del distrito de Chiclayo, Perú. Material y métodos: Estudio analítico de tipo casos y controles prospectivo en el que los pacientes provenientes de los consultorios de medicina interna y reumatología de 3 centros asistenciales, fueron evaluados mediante entrevista estructurada para datos clínicos y epidemiológicos y mediante los test de Zung para depresión y ansiedad. Se usó estadística descriptiva, frecuencias absolutas y relativas, se midieron los odds ratio (OR) para depresión y ansiedad y los intervalos de confianza, con un nivel de significancia de 0,05; se calcularon OR ajustados mediante regresión logística. Se utilizó el programa estadístico SPSS v17. Resultados: de 208 pacientes en total, 52 (25%) fueron casos y 156 (75%) controles. Hubo mayor frecuencia de Síndrome de Fibromialgia en las mujeres 48 (92%); la mayoría de pacientes con Fibromialgia tuvieron algún  grado de Depresión y Ansiedad: 50 (96,2) y 48 (92,3%) respectivamente; la depresión fue en mayor medida de tipo severa 20 (38,4%) y el nivel de ansiedad más frecuente fue el tipo mínimo-moderada 26 (50%). En  el análisis multivariado, se halló asociación entre Síndrome de Fibromialgia y  ansiedad (OR=9,7 IC95% 3,1-29,5); mas no con depresión (OR=1,48 IC95% 0,27-8). Conclusión: la frecuencia de ansiedad y depresión en pacientes con síndrome de fibromialgia fue elevada. Sólo se halló asociación entre ésta y ansiedad

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 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 <1.1 kg m–2 in the vast majority of 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

Effects of pre-operative isolation on postoperative pulmonary complications after elective surgery: an international prospective cohort study an international prospective cohort study

We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care. We aimed to determine the impact of pre-operative isolation on postoperative pulmonary complications after elective surgery during the global SARS-CoV-2 pandemic. We performed an international prospective cohort study including patients undergoing elective surgery in October 2020. Isolation was defined as the period before surgery during which patients did not leave their house or receive visitors from outside their household. The primary outcome was postoperative pulmonary complications, adjusted in multivariable models for measured confounders. Pre-defined sub-group analyses were performed for the primary outcome. A total of 96,454 patients from 114 countries were included and overall, 26,948 (27.9%) patients isolated before surgery. Postoperative pulmonary complications were recorded in 1947 (2.0%) patients of which 227 (11.7%) were associated with SARS-CoV-2 infection. Patients who isolated pre-operatively were older, had more respiratory comorbidities and were more commonly from areas of high SARS-CoV-2 incidence and high-income countries. Although the overall rates of postoperative pulmonary complications were similar in those that isolated and those that did not (2.1% vs 2.0%, respectively), isolation was associated with higher rates of postoperative pulmonary complications after adjustment (adjusted OR 1.20, 95%CI 1.05–1.36, p = 0.005). Sensitivity analyses revealed no further differences when patients were categorised by: pre-operative testing; use of COVID-19-free pathways; or community SARS-CoV-2 prevalence. The rate of postoperative pulmonary complications increased with periods of isolation longer than 3 days, with an OR (95%CI) at 4–7 days or ≥ 8 days of 1.25 (1.04–1.48), p = 0.015 and 1.31 (1.11–1.55), p = 0.001, respectively. Isolation before elective surgery might be associated with a small but clinically important increased risk of postoperative pulmonary complications. Longer periods of isolation showed no reduction in the risk of postoperative pulmonary complications. These findings have significant implications for global provision of elective surgical care