Psychosocial telemonitoring and teleorientation for older adults in the Social Security (EsSalud) during the first six months of the COVID-19 pandemic in Peru

Introduction: The Peruvian Social Security during the COVID-19 pandemic implemented a psychosocial remote care program for older adults in order to improve their quality of life and prevent the development of mental problems. The study: Analysis of secondary data from records generated by teams from the Senior Centers at the national level between May and October 2020, with the aim to describe the experience of implementing Psychosocial telemonitoring and teleorientation for elderly patients during COVID-19 pandemic. Findings: A total of 154 280 follow-ups and 36 492 remote care services were provided to older adults. The main interventions provided were emotional support (75.5%) and social counseling (53.8%). The most recorded moods were calmness and worry. Feelings of worry, stress, sadness, and fear are higher in the reports with COVID-19 compared to those without COVID-19. Conclusion: Psychosocial telemonitoring and teleorientation for older adults can be used as another way to provide comprehensive care in elderly population.Revisión por pare

Calidad de vida de adultos mayores de la Seguridad Social peruana durante la pandemia por COVID-19

Objetive: To evaluate the quality of life of older adults who belong to the Seniors Centers (CAM) of the Social Security during the COVID-19 pandemic. Material and methods: Data were collected through telephone calls to older adults aged 60 years and over in the CAM. Quality of life was assessed with the EQ-5D-3L questionnaire, which considers the dimensions of mobility, self-care, activities of daily living, pain/discomfort and anxiety/depression and an analog scale from 0 to 100. The presence of depression, anxiety, comorbidities and functional status were also measured. A bivariate analysis with nonparametric tests was performed to assess the association between covariates and the quality of life analog scale. In addition, a simple regression analysis was performed using generalized linear models of the Poisson family to evaluate variables associated with the presence of problems in the quality of life dimensions. Results: A total of 99 older adults participated, mostly women (84.9%) and with an average age of 73.1 years, 83.3% had a higher education level and 86.7% lived with their spouse. Older adults with obesity, lung disease, inability to manage their own money, feeling fatigued, and hearing problems reported a lower than average score (<78.9) on the analogous quality of life scale. Osteoarticular diseases and feeling fatigued increase the likelihood of having problems with mobility, performing daily activities, and pain/discomfort. Conclusions: Older adults quality of life is influenced by multiple factors that must be addressed to improve their physical and mental well-being.Revisión por pare

Development of 3D-Printed Orthopedic Insoles for Patients with Diabetes and Evaluation with Electronic Pressure Sensors

"The correct distribution of loads on foot, known as plantar pressures, is a relevant parameter for evaluating the evolution of some diseases. Anomalies can lead to pain and discomfort in other body parts. Diabetes changes foot tissues and compromises biomechanics, resulting in ulcers and, eventually, amputation. Customized insoles allow the redistribution of plantar pressures and are a complementary strategy to diabetes management. Nowadays, scanning and 3D printing technology can generate faster and more accurate customized insoles opening new opportunities for local medical device development. This study reports the development of 3D-printed insoles using two polymers, thermoplastic polyether-polyurethane and thermoplastic polyurethane polyester-based polymer, and the evaluation of plantar pressure distribution in walk trials using a clinical protocol and low-cost electronic system. The two 3D-printed insoles performed as well as a standard insole. No significant difference was found in average peak pressure distribution. The digital manufacturing workflow of customized insoles can be implemented in middle-income countries. Three-dimensionally printed insoles have the potential for diabetes management, and further material evaluations are needed before using them in health facilities.

Development of 3D-Printed Orthopedic Insoles for Patients with Diabetes and Evaluation with Electronic Pressure Sensors

The correct distribution of loads on foot, known as plantar pressures, is a relevant parameter for evaluating the evolution of some diseases. Anomalies can lead to pain and discomfort in other body parts. Diabetes changes foot tissues and compromises biomechanics, resulting in ulcers and, eventually, amputation. Customized insoles allow the redistribution of plantar pressures and are a complementary strategy to diabetes management. Nowadays, scanning and 3D printing technology can generate faster and more accurate customized insoles opening new opportunities for local medical device development. This study reports the development of 3D-printed insoles using two polymers, thermoplastic polyether-polyurethane and thermoplastic polyurethane polyester-based polymer, and the evaluation of plantar pressure distribution in walk trials using a clinical protocol and low-cost electronic system. The two 3D-printed insoles performed as well as a standard insole. No significant difference was found in average peak pressure distribution. The digital manufacturing workflow of customized insoles can be implemented in middle-income countries. Three-dimensionally printed insoles have the potential for diabetes management, and further material evaluations are needed before using them in health facilities.Revisión por pare

Development of 3D-Printed Orthopedic Insoles for Patients with Diabetes and Evaluation with Electronic Pressure Sensors

"The correct distribution of loads on foot, known as plantar pressures, is a relevant parameter for evaluating the evolution of some diseases. Anomalies can lead to pain and discomfort in other body parts. Diabetes changes foot tissues and compromises biomechanics, resulting in ulcers and, eventually, amputation. Customized insoles allow the redistribution of plantar pressures and are a complementary strategy to diabetes management. Nowadays, scanning and 3D printing technology can generate faster and more accurate customized insoles opening new opportunities for local medical device development. This study reports the development of 3D-printed insoles using two polymers, thermoplastic polyether-polyurethane and thermoplastic polyurethane polyester-based polymer, and the evaluation of plantar pressure distribution in walk trials using a clinical protocol and low-cost electronic system. The two 3D-printed insoles performed as well as a standard insole. No significant difference was found in average peak pressure distribution. The digital manufacturing workflow of customized insoles can be implemented in middle-income countries. Three-dimensionally printed insoles have the potential for diabetes management, and further material evaluations are needed before using them in health facilities.

Percepciones de aceptabilidad y reticencia a las vacunas contra la COVID-19 en el Perú

Objetivos. Explorar los factores que predisponen la aceptabilidad o reticencia a la vacunación contra la COVID-19 utilizando métodos cualitativos. Materiales y métodos. Estudio cualitativo descriptivo realizado entre abril y junio del 2021. Se utilizó una guía de entrevista semiestructurada que exploró las percepciones de los participantes de diferentes regiones del Perú con relación a la aplicación de la vacuna para la COVID-19, tomando como marco teórico el modelo de creencias en salud, cuyas dimensiones son: susceptibilidad, severidad, beneficios, barreras y estímulos asociados para ejecutar la acción. Resultados. Se entrevistó a treinta personas, en su mayoría mujeres. Para los participantes la eficacia de las vacunas se relaciona con el país de procedencia, además, consideran que es importante conocer los efectos a largo plazo en la salud luego de la aplicación de la vacuna. La información recibida por las autoridades gubernamentales y sanitarias puede ser un factor decisivo para la aplicación de la vacuna. Las personas con la intención de no vacunarse sienten que las estrategias de promoción de la vacunación vulneran sus derechos humanos. Conclusiones. Existe un grupo de personas indecisas o inseguras de recibir las vacunas contra la COVID-19 en quienes es necesario fomentar estímulos de acuerdo con sus preocupaciones y necesidades. Las autoridades gubernamentales y sanitarias deben trabajar conjuntamente para mejorar la confianza de la población y brindar mensajes que despejen las principales dudas sobre la eficacia y las reacciones adversas de las vacunas

Efecto antioxidante y citoprotector del tocosh de Solanum tuberosum ‘papa’ en la mucosa gástrica de animales de experimentación

El tocosh es un producto alimenticio obtenido por una técnica de conservación andina y que tiene propiedades nutritivas y terapéuticas. Objetivo: Demostrar la capacidad antioxidante y el efecto citoprotector del tocosh de Solanum tuberosum ‘papa’ en la mucosa gástrica de animales de experimentación. Diseño: Experimental. Institución: Centro de Investigación de Bioquímica y Nutrición, Facultad de Medicina, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material biológico: Tocosh seco y molido administrado a ratas albinas. Intervenciones: A 6 grupos de ratas albinas machos (200 ± 50 g) se les dividió en: (GI) solución NaCl 0,9%, 10 mL/kg; (GII) etanol al 70% a 10 mL/kg; (GIII, IV y V) Tocosh equivalente a 900 mg/kg, 1 800 mg/kg y 2 700 mg/kg, respectivamente, y (GVI) sucralfato 30 mg/kg. En todos los casos, una hora después se indujo injuria con etanol 70° a 10 mL/kg y por laparotomía abdominal se obtuvo el tejido gástrico. Principales medidas de resultados: Porcentaje de citoprotección gástrica en imagen digitalizada por image analysis software for plant disease quantification y capacidad antioxidante por lipoperoxidación método espectrofotométrico de la reacción de especies reactivas al ácido tiobarbitúrico (TBARS). Resultados: La marcha fitoquímica identificó compuestos fenólicos, alcaloides, triterpenoides y esteroides, azúcares reductores y aminoácidos libres como metabolitos secundarios. Las dosis de 2 700 mg/kg y 900 mg/kg resultaron en 0,72 y 1,81 nmol/g tejido de lipoperoxidación, respectivamente. La dosis de 1 800 mg/kg protegió un 97% del área de la mucosa gástrica, 2 700 mg/kg un 95% y la de 900 mg/kg, 88% (p&lt;0,05). La dosis de 1 800 mg/kg exhibió mejor efecto citoprotector y la de 2 700 mg/kg mejor actividad antioxidante, comparada con sucralfato 30 mg/kg. Conclusiones: El tocosh de Solanum tuberosum ‘papa’ tuvo efecto citoprotector y actividad antioxidante

Proceso de definición de prioridades institucionales de investigación en el Seguro Social de Salud del Perú, 2020-2022

Introduction: Health research priorities definition address research efforts to the promotion of health science, technology, and innovation. Material and Methods: Health research priorities in the Peruvian Social Security for the period 2020-2022 was carried out in four stages using a systematic, structured, participatory and sequential process. Results: First, the progress of the research in the priorities of the period 2017-2019 was evaluated. In the second stage, various sources were consulted to identify disease-oriented research needs and the framework for priorities oriented to health systems and health interventions. The third stage consisted of an expanded consultation to select priority disease-oriented topics. Finally, a participatory and multidisciplinary workshop was developed to select themes, subtopics, and priority areas for research. Conclusion: The final product was the definition of 11 priority themes, seven for diseases and four for health systems and health interventions.Introducción: La definición de prioridades de investigación en salud dirige los esfuerzos de investigación para promover ciencia, tecnología e innovación en salud. Material y Métodos: La definición de estas en el Seguro Social de Salud peruano para el periodo 2020-2022 se realizó en cuatro etapas y de forma sistemática, estructurada, participativa y secuencial. Resultados: Primero, se evaluó el avance de investigación en las prioridades del periodo 2017-2019. En la segunda etapa, se consultó diversas fuentes y se identificó necesidades de investigación orientadas a enfermedades y se estableció el marco para prioridades orientadas a sistemas de salud e intervenciones sanitarias. La tercera etapa consistió en una consulta ampliada para seleccionar los temas prioritarios orientados a enfermedades. Finalmente, se desarrolló un taller participativo y multidisciplinario para seleccionar temas, subtemas y áreas prioritarias de investigación. Conclusión: El producto final fue la definición de 11 temas prioritarios, siete para enfermedades y cuatro para sistemas de salud e intervenciones sanitarias

Life expectancy and mortality in 363 cities of Latin America

The concept of a so-called urban advantage in health ignores the possibility of heterogeneity in health outcomes across cities. Using a harmonized dataset from the SALURBAL project, we describe variability and predictors of life expectancy and proportionate mortality in 363 cities across nine Latin American countries. Life expectancy differed substantially across cities within the same country. Cause-specific mortality also varied across cities, with some causes of death (unintentional and violent injuries and deaths) showing large variation within countries, whereas other causes of death (communicable, maternal, neonatal and nutritional, cancer, cardiovascular disease and other noncommunicable diseases) varied substantially between countries. In multivariable mixed models, higher levels of education, water access and sanitation and less overcrowding were associated with longer life expectancy, a relatively lower proportion of communicable, maternal, neonatal and nutritional deaths and a higher proportion of deaths from cancer, cardiovascular disease and other noncommunicable diseases. These results highlight considerable heterogeneity in life expectancy and causes of death across cities of Latin America, revealing modifiable factors that could be amenable to urban policies aimed toward improving urban health in Latin America and more generally in other urban environments