Factores pronóstico de supervivencia en adultos por gliomas de alto grado en un hospital de Lima, Perú: Prognostic factors and survival study in high-grade glioma in a hospital in Lima, Peru

Introduction: Gliomas are primary tumors of the central nervous system. They are classifiedfrom grade I-IV, with high grade III and IV being the most frequent and with poor prognosis. Objective: To determine the prognostic factors of survival in patients with high-gradegliomas in a hospital in Lima, Peru. Methods: The medical records with high-grade gliomafrom 2010-2014 were retrospectively reviewed, ten variables were analyzed with Kaplan-Meier and Log Rank survival graphs and the Cox regression model. Results: Out of a total of278 patients with high-grade gliomas, 136 were men and 142 women. The analysis of Progression-Free Survival (SLP) had a range of 5.6-80.3 (median 22.7) and the analysis ofoverall survival (PS) had a range of 4-83.2 (median 26, 2 months. The overall survival for theIV grade tumor was 15.7 months (95% CI 14.2-17.1); the III degree was 38.4 months (95%CI 35.8-40.9). The grade (PS: HR 15; SLP: HR 25.1); surgical treatment (PS: HR 0.6; SLP:HR 0.49), age (PS: HR 1.47; SLP: HR 1.7), adjuvant treatment (PS: HR 0.6; SLP: HR 0 , 58)and karnofsky (PS: HR 0.7) were correlated; while the Karnofsky for SLP does not (P =0.146). Conclusion: age, functional status, surgical treatment, adjuvant treatment, and tumorgrade are prognostic factors for PS. In contrast, for SLP the prognostic factors were age,surgical treatment, adjuvant treatment, and tumor grade.Introducción: Los Gliomas son tumores primarios del sistema nervioso central. Son clasificados delI-IV grado, siendo los de alto grado el III y IV los más frecuentes y de pobre pronostico. Objetivo:Determinar los factores pronósticos de supervivencia en pacientes por gliomas de alto grado en unhospital de Lima, Perú. Métodos: Se revisaron retrospectivamente las historias clínicas con glioma dealto grado del 2010-2014, se analizaron diez variables; con graficas de supervivencia de Kaplan-Meiery Long-rank y el modelo de regresión de Cox. Resultados: De un total de 278 pacientes con gliomasde alto grado 136 fueron varones y 142 mujeres. El análisis de la Supervivencia Libre de Progresión(SLP) tuvo un rango de 5,6-80,3 (mediana 22,7) y el análisis de supervivencia global (PS) tuvo un rangode 4-83,2 (mediana 26,2) meses. La supervivencia global para el tumor de IV grado fue 15,7 meses (IC95% 14,2-17,1); el III grado fue de 38,4 meses (IC 95% 35,8-40,9). El grado (PS: HR 15; SLP: HR 25,1); eltratamiento quirúrgico (PS: HR 0,6; SLP: HR 0,49), edad (PS: HR 1,47; SLP: HR 1,7), tratamiento adyuvante(PS: HR 0,6; SLP: HR 0,58) y karnofsky (PS: HR 0,7) tuvieron correlación; mientras el Karnofsky paraSLP no (P=0,146). Conclusión: La edad, el estado funcional, el tratamiento quirúrgico, el tratamientoadyuvante y el grado del tumor son factores pronósticos de PS; en contraste, para SLP los factorespronósticos fueron la edad, tratamiento quirúrgico, tratamiento adyuvante y el grado del tumor

Factors associated with the use of dental services in diabetic people

The use of dental services prevents oral diseases where its prevalence is associated with chronic diseases such as diabetes mellitus (DM) that also has increased risks with age. Therefore, this observational, analytical and crosssectional study was conducted among 3,882 people. Data used for analysis in this research was collected from the Demographic and Family Health Survey of Peru (ENDES) from 2019 to 2021. Results from poisson regression analysis showed female gender had 1.02 times the probability of going to the dental service; likewise, people who were 91 to 100 years old had 12% more, the probability, like those with secondary education, had 8% more and those with the highest average, richest and richest wealth index had 20% more, 29% more and 29% more, respectively, the probability of going to the dental health service, as opposed to those who were very poor. The study concluded that there are several sociodemographic factors (such as being female, age progressed, natural region, those with high school, wealth index, type of residence) and personal factors (history of hypertension (HTN), physical disability) associated with a lack of access to dental services in people over 60 years old

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

Predictive power of a body shape index (ABSI) for diabetes mellitus and arterial hypertension in Peru: demographic and health survey analysis - 2020

Introduction: Given the relationship between obesity and type 2 diabetes mellitus (T2DM) and hypertension, an indicator of body fat, A Body Shape Index (ABSI), has been considered to have apparent predictive power for these diseases.Objective: To determine the predictive power of the ABSI for DMT2 and hypertension in Peru through the analysis of the Demographic and Health Survey-2020 (ENDES-by its acronym in Spanish-2020).Methods: Cross-sectional analytical study of the ENDES-2020. The variables evaluated were ABSI, body mass index, high abdominal waist, waist-to-height ratio, body roundness index (BRI) and conicity index (COI). Areas under the curves (AUC) together with their 95% confidence interval (95%CI) were used to present each index.Results: A total of 19 984 subjects were studied. Regarding hypertension, the highest AUC was presented by the COI: AUC=0.707 (95%CI 0.694-0.719). While the ABSI obtained the penultimate place: AUC=0.702 (95% CI 0.689-0.715). In case of DM2, the highest ABC was presented by BRI: AUC=0.716 (95%CI 0.689-0.743); while ABSI obtained the second place: AUC=0.687 (95%CI 0.658-0.717). Conclusions: The results demonstrate that ABSI is not a good predictor for hypertension and DMT2 in the Peruvian population. If these findings are confirmed by other studies, its use would not be recommended for these diseases, and other anthropometric indicators that could perform better should be further explored.Campus Lima Nort

Predictive Power of a Body Shape Index (ABSI) for Diabetes Mellitus and Arterial Hypertension in Peru: Demographic and Health Survey Analysis - 2020

Introduction: Given the relationship between obesity and type 2 diabetes mellitus (T2DM) and hypertension, an indicator of body fat, A Body Shape Index (ABSI), has been considered to have apparent predictive power for these diseases. Objective: To determine the predictive power of the ABSI for DMT2 and hypertension in Peru through the analysis of the Demographic and Health Survey-2020 (ENDES-by its acronym in Spanish-2020). Methods: Cross-sectional analytical study of the ENDES-2020. The variables evaluated were ABSI, body mass index, high abdominal waist, waist-to-height ratio, body roundness index (BRI) and conicity index (COI). Areas under the curves (AUC) together with their 95% confidence interval (95%CI) were used to present each index. Results: A total of 19 984 subjects were studied. Regarding hypertension, the highest AUC was presented by the COI: AUC=0.707 (95%CI 0.694-0.719). While the ABSI obtained the penultimate place: AUC=0.702 (95% CI 0.689-0.715). In case of DM2, the highest ABC was presented by BRI: AUC=0.716 (95%CI 0.689-0.743); while ABSI obtained the second place: AUC=0.687 (95%CI 0.658-0.717). Conclusions: The results demonstrate that ABSI is not a good predictor for hypertension and DMT2 in the Peruvian population. If these findings are confirmed by other studies, its use would not be recommended for these diseases, and other anthropometric indicators that could perform better should be further explored

Utilidad diagnóstica de la prueba de riesgo de la Asociación Americana de Diabetes para prediabetes y diabetes. Una revisión sistemática y metaanálisis

Introducción. Dado el aumento de los casos de prediabetes y diabetes mellitus tipo 2 (DM2) a nivel mundial, y al poco acceso de análisis de laboratorio en varios lugares, es necesario contar con la implementación de un método de detección simple, rápido y sin laboratorio: la prueba de riesgo de la Asociación Americana de Diabetes (ADA): el ADA test risk score (ADATRS). Objetivo. Realizar una revisión sistemática (RS) con metaanálisis sobre la utilidad diagnóstica del ADATRS para prediabetes y DM2. Materiales. RS con metaanálisis de estudios de pruebas diagnósticas. Se realizó la búsqueda en cuatro bases de datos: PubMed/Medline, SCOPUS, Web of Science y EMBASE. Se obtuvieron los verdadero positivos, verdaderos negativos, falsos positivos y falsos negativos de cada estudio. Se construyeron tablas de 2×2 con base en la información del artículo o de los autores. Así, se presentaron diagramas de bosque con un intervalo de confianza al 95% (IC 95%), tanto de la sensibilidad como especificidad en conjunto del ADATRS para ambos eventos de interés. Resultados. Los diagramas de bosque revelaron que la sensibilidad y especificidad para prediabetes fueron 0,91 (IC95%: 0,82–0,96) y 0,52 (IC95%: 0,36–0,67), respectivamente. Mientras que, para DM2, la sensibilidad y especificidad, combinados fueron 0,85 (IC95%: 0,71–0,93) y 0,56 (IC95%: 0,47–0,65), respectivamente. Conclusiones. Nuestra revisión sistemática y metanálisis de la literatura actual sugiere que el ADATRS puede ser útil como método de cribado para prediabetes y DM2, dado su alta sensibilidad. Sin embargo, existe mucha heterogeneidad y pocos estudios aun al respecto; por lo tanto, se necesitan más trabajos de investigación en diferentes poblaciones y con métodos más estandarizados para finalmente determinar la importancia clínica de este cuestionario como herramienta de cribado o diagnóstico para la prediabetes o DM2

Metabolically Obese Normal-Weight Phenotype as a Risk Factor for High Blood Pressure: A Five-Year Cohort

"Background: The metabolically obese normal-weight (MONW) phenotype has been considered a risk factor for different chronic diseases, but its role in high blood pressure (HBP) is still unclear. The aim of the study is to determine if the MONW phenotype constitutes a risk factor for hypertension in Peruvian adults belonging to a 5-year cohort. Methods: This is a retrospective cohort study. A secondary analysis from the database of the PERU MIGRANT study was carried out from the MONW and non-MONW cohorts; after a 5-year follow-up, the appearance of HBP was evaluated in the subjects of both cohorts. To assess the strength and magnitude of the association, a Poisson regression model (crude and adjusted) with robust variance was used. The measure of association was the relative risk (RR). Results: The incidence of HBP was 11.30%. In the multivariable analysis, subjects with the MONW phenotype had a 2.879-fold risk of presenting HBP in 5 years compared with those who were not MONW at the beginning of the study; this was adjusted for categorized age, sex, group, and state of smoker and alcohol drinker (RR: 2.055; 95% confidence interval (CI): 1.118 - 3.777; P = 0.020). Conclusions: The presence of the MONW phenotype doubled the incidence of HBP, even after adjusting for other covariates. However, studies in this field should continue. If these findings are confirmed, it should be considered that presenting an adequate weight for height should not be interpreted as a condition free of metabolic alterations, so screening for hypertension should be carried out regardless of w

Asociación entre enfermedad por reflujo gastroesofágico e intensidad de la actividad física en una muestra de pobladores peruanos

Introducción: la nutrición adecuada, dejar de fumar y de beber alcohol son medidas preventivas y de tratamiento, ayudan a prevenir complicaciones de la enfermedad por reflujo gastroesofágico. Sin embargo, aún existen dudas sobre la intensidad de la actividad física y sus beneficios en el desarrollo de esta enfermedad. Objetivo: determinar la asociación entre la actividad física y la enfermedad por reflujo gastroesofágico en una muestra de peruanos. Metodología: estudio transversal analítico que utilizo una base de datos secundarias del estudio COHORT CRONICAS. La variable principal fue la presencia o no de enfermedad por reflujo gastroesofágico, lo cual se determinó a través de un autoinforme por diagnóstico médico. La variable independiente fue la actividad física, cuyos niveles fueron definidos de acuerdo con el protocolo del cuestionario internacional de actividad física, la que se dicotomizó en “bajo” y “medio/alto”. Resultados: se trabajó con un total de 3211 sujetos. La prevalencia de reflujo gastroesofágico fue 4,48% y el 5,36% practicaba actividad física moderada/alta. En la regresión múltiple, se observó que los pacientes con actividad física baja tenían 391% mayor frecuencia de presentar reflujo gastroesofágico, respecto a quienes realizaban actividad física moderado/alta. Luego del ajuste de las covariables: sexo, edad,estatus socioeconómico, estado de fumador, bebedor de alcohol, actividad física e índice de masa corporal; se obtuvo un RP=4,91; IC95%: 1,19 –20,23. Conclusiones: el estudio mostró que la actividad física de intensidad moderada/alta se asocia con una menor prevalencia de enfermedad por reflujo gastroesofágico. Si los resultados actuales se confirman en investigaciones futuras, los hallazgos de este estudio podrían ser importantes para la prevención y el tratamiento del reflujo gastroesofágico, a través dela intensidad de la actividad física.Campus Lima Nort

Metabolically Obese Normal-Weight Phenotype as a Risk Factor for High Blood Pressure: A Five-Year Cohort

Background: The metabolically obese normal-weight (MONW) phenotype has been considered a risk factor for different chronic diseases, but its role in high blood pressure (HBP) is still unclear. The aim of the study is to determine if the MONW phenotype constitutes a risk factor for hypertension in Peruvian adults belonging to a 5-year cohort. Methods: This is a retrospective cohort study. A secondary analysis from the database of the PERU MIGRANT study was carried out from the MONW and non-MONW cohorts; after a 5-year follow-up, the appearance of HBP was evaluated in the subjects of both cohorts. To assess the strength and magnitude of the association, a Poisson regression model (crude and adjusted) with robust variance was used. The measure of association was the relative risk (RR). Results: The incidence of HBP was 11.30%. In the multivariable analysis, subjects with the MONW phenotype had a 2.879-fold risk of presenting HBP in 5 years compared with those who were not MONW at the beginning of the study; this was adjusted for categorized age, sex, group, and state of smoker and alcohol drinker (RR: 2.055; 95% confidence interval (CI): 1.118 - 3.777; P = 0.020). Conclusions: The presence of the MONW phenotype doubled the incidence of HBP, even after adjusting for other covariates. However, studies in this field should continue. If these findings are confirmed, it should be considered that presenting an adequate weight for height should not be interpreted as a condition free of metabolic alterations, so screening for hypertension should be carried out regardless of whether or not the body mass index obtained is considered normal

Factors associated with adherence to the Mediterranean diet among medical students at a private university in Lima, Peru

Introduction: The Mediterranean diet (MedD)is a characteristic eating pattern of the countries of the Mediterranean region. Nonetheless, is unknown its adherence in medical students. We aimed to determine the prevalence of adherence to the Mediterranean diet (AMedD) and associated factors in medical students from Peru. Material and methods: Analytical cross-sectional study carried out by means of a virtual survey. PREDIMED scale was used to evaluate AMedD. The factors assessed were age, sex, academic year, body mass index (BMI), place of lunch consumption, cigarette smoking, and physical activity. Poisson regression with robust variance was used to present it in crude and adjusted prevalence ratios (PRa). Results: High AMedD was present in 38.50%. Statistically significant association was found for sex (PRa: 0.623; 95%CI 0.488-0.796); for overweight (PRa: 0.417; 95%CI 0.270-0.644), obesity (PRa: 0.591; 95%CI 0.400-0.874) versus normopese; cigarette smoking (PRa: 0.450; 95%CI 0.263-0.773); and high physical activity (PRa: 1.652; 95%CI 1.233- 2.215). Conclusions: AMedD was low. The related factors were sex, BMI, consumption of lunch outside the home, cigarette smoking, anda high level of physical activity. Ifthis is confirmed in future studies, it would be necessary to consider these elements to encourage greater consumption of MedD components by students, which would help to improve their long-term health