Validez de la prueba de riesgo de la Asociación Americana de Diabetes como cribado para prediabetes en una muestra de trabajadores peruanos: Validity of the American Diabetes association Diabetes risk test as screening for Prediabetes in a sample of peruvian workers.

Objective: To evaluate the validity of the risk test of the American Diabetes Association (ADA Test) as a screening for hyperglycemia in a sample of workers in Lima, Peru. Methods: Cross-sectional study of diagnostic tests. Secondary analysis of the data generated by the electronic health record of an occupational polyclinic, carried out in January and February 2020. The sample was made up of workers from different areas who attended for their occupational medical evaluation. Prediabetes was considered with a fasting glucose ≥ 100 mg / dl but less than 126 mg / dl. Results: 397 subjects were evaluated. The prevalence of hyperglycemia was 29% (115/397). With a cutoff ≥ 3 points, the ADA Test presented an area under the curve of 0.868, a sensitivity of 94.8%, and a specificity of 51.8%. The PPV was 44.5% and the NPV was 96.1%. Finally, the positive likelihood coefficient calculated was 1.96, and the negative was 0.101. Conclusion: The ADA test, with a 3-point cutoff, proves to be a simple pragmatic screening tool for undiagnosed cases of prediabetes. If current results are confirmed in future research, due to its simplicity, it can facilitate various initiatives aimed at introducing and expanding early prevention and management strategies based on this trial.Objetivo: Evaluar la validez de la prueba de riesgo de la Asociación Americana de Diabetes (Prueba ADA) como cribado para prediabetes en una muestra de trabajadores peruanos. Métodos: Estudio transversal de pruebas diagnósticas. Análisis secundario de los datos generados por el registro electrónico en salud de un policlínico ocupacional, realizado en los meses enero y febrero del año 2020. La muestra estuvo conformada por trabajadores de diferentes áreas que asistieron para su evaluación médica ocupacional. Se consideró prediabetes con una glucosa en ayunas ≥ 100 mg/dl pero menor a 126 mg/dl. Resultados: Se evaluaron 397 sujetos. La prevalencia de prediabetes fue 29% (115/397). Con un corte ≥ 3 puntos, la Prueba ADA presentó un área bajo la curva de 0.868, una sensibilidad del 94,8% y una especificidad del 51,8%. El valor predictivo positio fue de 44,5% y negativo fue de 96,1%. Por último, el coeficiente de verosimilitud positivo calculado fue de 1,96, y el negativo fue de 0,101. Conclusión: La prueba ADA, con un corte de 3 puntos, demuestra ser una herramienta de detección pragmática simple para casos no diagnosticados de prediabetes. Si los resultados actuales se confirman en investigaciones futuras, debido a su simplicidad, puede facilitar diversas iniciativas orientadas a introducir y ampliar estrategias de gestión y prevención temprana a partir de esta prueba

Cintura hipertrigliceridémica y su asociación con la hipertensión arterial una muestra de pobladores adultos peruanos: Hypertriglyceridemic waist circumference and its association with arterial hypertension in a sample of Peruvian adult population

Objective: To evaluate the prevalence of hypertriglyceridemic waist (HTGW) and its association with arterial hypertension (AHT) in Peruvian adults. Methodology: Cross-sectional analytical study of the secondary database from the "National Survey of Nutritional, Biochemical, Socioeconomic and Cultural Indicators related to Chronic-Degenerative Diseases". HTGW was measured according to the presence of hypertriglyceridemia (≥ 150 mg/dl) and increased abdominal waist, according to JIS (men ≥ 94 cm and women ≥ 80 cm) and ATPIII (men ≥ 102 cm and women ≥ 88 cm) criteria. Results: the prevalence of AHT was 12.48%, HTGW -JIS was 21.49%, and HTGW-ATPII was 13.96%. In multiple regression, HTGW-JIS showed that they had 1.35 higher frequency of having AHT versus those without HTGW (PR=1.35; CI95%: 1.13 - 1.61; p = 0.001) and HTGW-ATPIII showed that they had 1.38 higher frequency of having AHT versus those without HTGW (PR=1.38; CI95%: 1.14 - 1.67; p = 0.001), both adjusted for convenience variables. Conclusion: HTGW was positively associated with AHT.Objetivo: Evaluar la prevalencia de cintura hipertrigliceridémica (CHTG) y su asociación con hipertensión arterial (HTA) en pobladores adultos peruanos. Metodología: Estudio transversal analítico de base de datos secundario de la “Encuesta Nacional de Indicadores Nutricionales, Bioquímicos, Socioeconómicos y Culturales relacionados con las Enfermedades Crónicas-Degenerativas”. La CHTG se midió de acuerdo con la presencia de hipertrigliceridémica (≥ 150 mg/dl) y cintura abdominal aumentada, según los criterios JIS (hombres ≥ 94 cm y mujeres ≥ 80 cm) y ATPIII (hombres ≥ 102 cm y mujeres ≥ 88 cm). Resultados: La prevalencia de HTA fue 12,48 %, de CHTG-JIS fue 21,49% y CHTG-ATPII fue 13,96%. En la regresión múltiple, la CHTG-JIS mostro que tenían 1,35 mayor frecuencia de tener HTA versus quienes no presentaban CHTG (RP=1,35; IC95%: 1,13 – 1,61; p = 0.001) y la CHTG-ATPIII observó que tenían 1,38 mayor frecuencia de tener HTA versus quienes no presentaban CHTG (RP=1,38; IC95%: 1,14 – 1,67; p=0.001), ambos ajustados por variables convenientes. Conclusión: La CHTG se asoció positivamente con HTA

Post-Traumatic Stress Associated with Telework-Related Job Limitation in Latin America

During the pandemic, there has been evidence of work limitations during telework, which are believed to cause mental health problems. Our objective was to assess the association between perceived work limitations during telework and posttraumatic stress during the COVID-19 pandemic in Latin America. A cross-sectional study was conducted in Latin America in 2020. Exposure was measured by self-reporting using a self-perception questionnaire; the SPRINT-E questionnaire was used for outcome measurements. Generalized linear models were applied. Of 1329 participants, 15.2% (n = 202) had posttraumatic stress. In a multivariate analysis, the highest frequency of posttraumatic stress was found among those with moderate depression or more (PR = 1.29; 95% CI: 1.03–1.61), moderate or more anxiety (PR = 2.34; 95% CI: 1.61–3.41), and moderate or more stress (PR = 2.45; 95% CI: 1.46–4.12). In conclusion, there is an association between perceived work limitations during telework and posttraumatic stress in Latin American workers. For this reason, it is recommended that occupational physicians, companies, and institutions assess the frequency of posttraumatic stress and monitor the mental health of workers.National Institute of Mental HealthRevisión por pare

Factores asociados a seropositividad para SARS-CoV-2 en pacientes atendidos en un hospital de zona altoandina peruana

Background: COVID 19 is an infectious disease caused by SARS-CoV-2 that has affected Peru on a large scale. Potential clinical and/or epidemiological factors that are related to the positivity of SARS-CoV-2 in the high Andean population are not documented. Objective: To determine factors associated with positivity of SARS-CoV-2 in people living in Ancash. Material and methods: Analytical transversal study. We used the records of patients treated for suspected COVID-19 in a public hospital in Huaraz in March-May 2020. Prevalence ratios (PR) with confidence intervals were estimated. In simple regression analysis, prevalence ratios and 95% confidence intervals were estimated, using Poisson distribution family, log-link function and robust variance. Results: Out of 903 patients, 13.7% tested positive for SARS-CoV-2. In simple regression, male (RP=2.98), cough (RP=2.27), respiratory distress (RP=2.97), diarrhea (RP=2.69), general malaise (RP=1.82), odynophagia (RP=1.69) were positively associated with having a positive SARS-CoV-2 test. In the multiple regressions, the association was maintained in four characteristics: being male (RP=2.7), having a cough (RP=1.45), respiratory distress (RP=2.15), and diarrhea (RP=1.89). Conclusion: In high Andean areas, most positive cases present typical symptoms. The factors associated with positivity were male sex and the presence of cough, respiratory difficulty and diarrhea.Introducción: El COVID 19 es una enfermedad infecciosa causada por el SARS-CoV-2 que ha afectado en gran escala al Perú. No están documentados los potenciales factores clínicos y/o epidemiológicos que están relacionados a la positividad de SARS-CoV-2 en población altoandina. Objetivo: Determinar los factores asociados a positividad de SARS-Cov-2 en personas que viven en Ancash. Material y métodos: Estudio transversal analítico. Se utilizaron los registros de pacientes atendidos por sospecha de COVID-19 en un hospital público de Huaraz en marzo-mayo 2020. Se estimaron razones de prevalencia (RP) con intervalos de confianza. En el análisis de regresión simple, se estimaron razones de prevalencia e intervalos de confianza al 95%, utilizando familia de distribución Poisson, función de enlace log y varianza robusta Resultados: De 903 pacientes, 13,7% pacientes resultaron positivos a SARS-CoV-2. En la regresión simple, resultó que el sexo masculino (RP=2,98), presentar tos (RP=2,27), dificultad respiratoria (RP=2,97), diarrea (RP=2,69), malestar general (RP=1,82), odinofagia (RP=1,69) se asociaron positivamente a tener prueba SARS-CoV-2 positiva. En la regresión múltiple se mantuvo la asociación en cuatro características: ser varón (RP=2,7), presentar tos (RP=1,45), dificultad respiratoria (RP=2,15) y diarrea (RP=1,89). Conclusión: En zona altoandina, los casos positivos en su mayoría presentan síntomas típicos. Los factores asociados a la positividad fueron el sexo masculino y la presencia de dificultad tos, respiratoria y diarrea

Content validity by expert judgment of an instrument to measure knowledge, attitudes and practices regarding salt consumption in the population of Peru

Introduction: Given the high consumption of salt in the population, there is a need to have a validated tool that measures the knowledge, attitudes, and practices of salt consumption (CAP-salt). Objective: To validate the CAP-salt questionnaire. Methods: Psychometric study of content validity through expert judgment. A total of ve physicians from different specialties were counted. To calculate the degree of agreement between the expert judges, Aiken's V was used as the decision criterion to keep an item; a value ≥ 0.7 was considered. Results: To clarify, V values greater than 0.80 were presented, in addition to a variation coefficient of less than 25%; therefore, none of the items was eliminated. Regarding coherence, they presented a coefficient of variation above 20% and V values greater than 0.71, conrming the decision not to exclude any of them. Regarding the relevance of the items, V values higher than 0.90 were also evidenced, and neither did any of them present a value below the critical one. Conclusions: The questionnaire has presented sufficient evidence of content validity in terms of clarity, coherence, and relevance of the items through the analyses mentioned above. For this reason, it should be used to quantify the CAP-salt of different population groups in the country.Campus Lima Nort

The Fruit Intake–Adiposity Paradox: Findings from a Peruvian Cross-Sectional Study

"Due to the increase in obesity worldwide, international organizations have promoted the adoption of a healthy lifestyle, as part of which fruit consumption stands out. However, there are controversies regarding the role of fruit consumption in mitigating this disease. The objective of the present study was to analyze the association between fruit intake and body mass index (BMI) and waist circumference (WC) in a representative sample of Peruvians. This is an analytical cross-sectional study. Secondary data analysis was conducted using information from the Demographic and Health Survey of Peru (2019–2021). The outcome variables were BMI and WC. The exploratory variable was fruit intake, which was expressed in three different presentations: portion, salad, and juice. A generalized linear model of the Gaussian family and identity link function were performed to obtain the crude and adjusted beta coefficients. A total of 98,741 subjects were included in the study. Females comprised 54.4% of the sample. In the multivariate analysis, for each serving of fruit intake, the BMI decreased by 0.15 kg/m2 (β = −0.15; 95% CI −0.24 to −0.07), while the WC was reduced by 0.40 cm (β = −0.40; 95% CI −0.52 to −0.27). A negative association between fruit salad intake and WC was found (β = −0.28; 95% CI −0.56 to −0.01). No statistically significant association between fruit salad intake and BMI was found. In the case of fruit juice, for each glass of juice consumed, the BMI increased by 0.27 kg/m2 (β = 0.27; 95% CI 0.14 to 0.40), while the WC increased by 0.40 cm (β = 0.40; 95% CI 0.20 to 0.60). Fruit intake per serving is negatively related to general body adiposity and central fat distribution, while fruit salad intake is negatively related to central distribution adiposity. However, the consumption of fruit in the form of juices is positively associated with a significant increase in BMI and WC.

The Fruit Intake–Adiposity Paradox: Findings from a Peruvian Cross-Sectional Study

"Due to the increase in obesity worldwide, international organizations have promoted the adoption of a healthy lifestyle, as part of which fruit consumption stands out. However, there are controversies regarding the role of fruit consumption in mitigating this disease. The objective of the present study was to analyze the association between fruit intake and body mass index (BMI) and waist circumference (WC) in a representative sample of Peruvians. This is an analytical cross-sectional study. Secondary data analysis was conducted using information from the Demographic and Health Survey of Peru (2019–2021). The outcome variables were BMI and WC. The exploratory variable was fruit intake, which was expressed in three different presentations: portion, salad, and juice. A generalized linear model of the Gaussian family and identity link function were performed to obtain the crude and adjusted beta coefficients. A total of 98,741 subjects were included in the study. Females comprised 54.4% of the sample. In the multivariate analysis, for each serving of fruit intake, the BMI decreased by 0.15 kg/m2 (β = −0.15; 95% CI −0.24 to −0.07), while the WC was reduced by 0.40 cm (β = −0.40; 95% CI −0.52 to −0.27). A negative association between fruit salad intake and WC was found (β = −0.28; 95% CI −0.56 to −0.01). No statistically significant association between fruit salad intake and BMI was found. In the case of fruit juice, for each glass of juice consumed, the BMI increased by 0.27 kg/m2 (β = 0.27; 95% CI 0.14 to 0.40), while the WC increased by 0.40 cm (β = 0.40; 95% CI 0.20 to 0.60). Fruit intake per serving is negatively related to general body adiposity and central fat distribution, while fruit salad intake is negatively related to central distribution adiposity. However, the consumption of fruit in the form of juices is positively associated with a significant increase in BMI and WC.

The Fruit Intake–Adiposity Paradox: Findings from a Peruvian Cross-Sectional Study

Due to the increase in obesity worldwide, international organizations have promoted the adoption of a healthy lifestyle, as part of which fruit consumption stands out. However, there are controversies regarding the role of fruit consumption in mitigating this disease. The objective of the present study was to analyze the association between fruit intake and body mass index (BMI) and waist circumference (WC) in a representative sample of Peruvians. This is an analytical cross-sectional study. Secondary data analysis was conducted using information from the Demographic and Health Survey of Peru (2019–2021). The outcome variables were BMI and WC. The exploratory variable was fruit intake, which was expressed in three different presentations: portion, salad, and juice. A generalized linear model of the Gaussian family and identity link function were performed to obtain the crude and adjusted beta coefficients. A total of 98,741 subjects were included in the study. Females comprised 54.4% of the sample. In the multivariate analysis, for each serving of fruit intake, the BMI decreased by 0.15 kg/m2 (β = −0.15; 95% CI −0.24 to −0.07), while the WC was reduced by 0.40 cm (β = −0.40; 95% CI −0.52 to −0.27). A negative association between fruit salad intake and WC was found (β = −0.28; 95% CI −0.56 to −0.01). No statistically significant association between fruit salad intake and BMI was found. In the case of fruit juice, for each glass of juice consumed, the BMI increased by 0.27 kg/m2 (β = 0.27; 95% CI 0.14 to 0.40), while the WC increased by 0.40 cm (β = 0.40; 95% CI 0.20 to 0.60). Fruit intake per serving is negatively related to general body adiposity and central fat distribution, while fruit salad intake is negatively related to central distribution adiposity. However, the consumption of fruit in the form of juices is positively associated with a significant increase in BMI and WC

Factors associated with psychological copingwith COVID-19 during quarantine period

Introducción: Aunque se está generando múltiple evidencia clínica sobre la COVID-19, también es crítico abordar sobre las estrategias y acciones que han adoptado las personas para enfrentar situaciones estresantes durante la cuarentena obligatoria debido a la pandemia. Objetivo: Determinar los factores asociados al afrontamiento psicológico frente a la COVID-19 en la población general. Métodos: Estudio transversal analítico. Se reclutaron los participantes a través de una encuesta en línea, durante el periodo de pandemia por la COVID-19. Se evaluó el nivel de afrontamiento pasivo y activo, utilizando la escala de afrontamiento frente a riesgos extremos. Adicionalmente, se utilizó la media de los puntajes de afrontamiento pasivo y activo, se evaluó la asociación con variables sociodemográficas, pertenencia a grupos, cumplimiento de aislamiento social y reporte de conocer alguien diagnosticado con la COVID-19. Se estimaron razones de prevalencia (RP) con el uso de modelos lineales generalizados. Resultados: De 463 participantes, la mayoría era peruano (67,4%), cumplía totalmente las medidas de aislamiento social (78,4%). La media de puntuación de afrontamiento activo y pasivo fue de 54,1 y 30,3, respectivamente. El 57,2 % y 54 % de los participantes presentó nivel de afrontamiento activo y pasivo superior a la media, respectivamente. Los factores asociados a alto nivel de afrontamiento activo fueron alto nivel educativo (RP= 1,23) y cumplir completamente las medidas de aislamiento social (RP = 1,35). Conclusión: Tener alto nivel educativo y el cumplimiento del aislamiento social estuvieron asociados positivamente a alto nivel de afrontamiento activo.Introduction: Although multiple clinical evidence is being generated about COVID-19, it is also critical to address the strategies and actions that people have adopted to face stressful situations during the mandatory quarantine due to the pandemic. Objective: To determine the factors associated with psychological coping to COVID-19 in the general population. Method: Analytical cross-sectional study. Participants were recruited through an online survey during the COVID-19 pandemic period. The level of passive and active coping was evaluated, using the coping scale against extreme risks. Additionally, usingthe mean of the passive and active coping scores, the association with sociodemographic variables, group membership, compliance with social isolation and the report of knowing someone diagnosed with COVID-19 was evaluated. Prevalence ratios (PR) were estimated using generalized linear models. Results: Of 463 participants, the majority was Peruvian (67,4 %),fully complying with social isolation measures (78,4 %). The meanactive and passive coping scores were 54,1 and 30,3, respectively.57,2 % and 54 % of the participants presented a level of active and passive coping above the mean, respectively. The factors associated with a high level of active coping were a higheducational level (RP = 1,23) and complete compliance with socialisolation measures (RP = 1,35). Conclusion: Having a high educational level and compliance withsocial isolation were positively associated with a high level ofactive coping.Campus Lima Nort

Diagnostic Accuracy of Anthropometric Markers of Obesity for Prediabetes: A Systematic Review and Meta-Analysis

Introduction: Prediabetes is a significant public health concern due to its high risk of progressing to diabetes. Anthropometric measures of obesity, including body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) have been demonstrated as key risk factors in the development of prediabetes. However, there is a lack of clarity on the diagnostic accuracy and cut-off points of these measures. Objective: To determine the diagnostic accuracy of these anthropometric measures for their most effective use in identifying prediabetes. Methodology: A systematic review (SR) with metanalysis of observational studies was carried out. The search was conducted in four databases: Pubmed/Medline, SCOPUS, Web of Science, and EMBASE. For the meta-analysis, sensitivity and specificity, together with their 95% confidence intervals (CI 95%) were calculated. Results: Among all the manuscripts chosen for review, we had four cross-sectional studies, and three were classified as cohort studies. The forest plots showed the combined sensitivity and specificity for both cross-sectional and cohort studies. For cross-sectional studies, the values were as follows: BMI had a sensitivity of 0.63 and specificity of 0.56, WC had a sensitivity of 0.59 and specificity of 0.58, and WHtR had a sensitivity of 0.63 and specificity of 0.73. In the cohort studies, the combined sensitivity and specificity were: BMI at 0.70 and 0.45, WC at 0.68 and 0.56, and WHtR at 0.68 and 0.56, respectively. All values are provided with 95% confidence intervals. Conclusions: This systematic review and meta-analysis evaluated the diagnostic accuracy of BMI, WC, and WHtR in identifying prediabetes. The results showed variations in sensitivity and specificity, with WHtR having the highest specificity in cross-sectional studies and BMI having improved sensitivity in cohort studies