FACTORES PREDICTIVOS DE NO EFECTIVIDAD A BETALACTAMICOS EN PACIENTES HOSPITALIZADOS POR INFECCIÓN DEL TRACTO URINARIO EN EL HOSPITAL SANTA ROSA DE LIMA

Objetivo: Determinar cuáles son los factores de riesgo predictivos para la no efectividad de uso de Betalactámicos en pacientes hospitalizados por Infeccion del Tracto Urinario (ITU) en el servicio de medicina interna del Hospital Santa Rosa de Lima. Métodos: Estudio observacional, Analítico, de casos y controles, realizado en el Hospital Santa Rosa ; 280 pacientes hospitalizados con ITU, 140 casos y 140 controles, en el periodo enero-diciembre 2016 fueron incluidos, las variables a analizar fueron: Edad, Sexo, Diabetes Mellitus tipo 2, Enfeemedad Renal Cronica y hospitalizaciones previas. Resultados: Como resultado del análisis la variable Diabetes Mellitus 2 presento un OR: 7.79  IC 95% (4.57-13.27), Enfermedad renal crónica OR: 24.06 IC 95% (12.04- 48.07), Hospitalización previa OR: 3.93 IC 95% (2.37- 6.51) Siendo considerados como factores de asociación positivos y significativamente estadísticos. Conclusión: La población en su mayoría se caracterizó por ser predominantemente femenino y menor de 65 años; el tener diabetes mellitus 2, Enfermedad renal crónica y hospitalización previa fueron factores asociados positiva y estadísticamente significativos, para la no efectividad del uso de betalactámicos en pacientes hospitalizados con ITU. Palabras clave: Sistema Urinario; No efectividad antibiótica; Factores predictivos asociados. (fuente: DeCS BIREME) DOI: https://doi.org/10.25176/RFMH.v17.n4.121

Access to Dental Services among Hypertensive Elderly in Peru: Exploring Patterns and Implications

Background: This study was conducted to determine access to dental services in the elderly with hypertension in Peru. Methods: Observational, analytical, and cross-sectional design. Data used for analysis in this research was collected from the Demographic and Family Health Survey of Peru (ENDES) from 2019 to 2021. Results: A Poisson regression analysis was performed a weighted sample for calculating prevalence ratio (PR) with their 95% confidence intervals (95%CI). The multiple regression analysis did not find among the factors associated with the probability of using the dental health service, since neither the time less than two years of hypertension (PR=0.74, 95%CI 0.53 – 1.02); nor from 2 to 4 years (PR = 0.97, CI 95% 0.86 – 1.09); neither a time of hypertension from 5 years or more (PR = 0.94, CI 95% 0.85 – 1.03) were associated. Conclusion: The study concluded that hypertensive patient over 60 years of age, despite a previous diagnosis of hypertension or not, does not attend dental service, reflecting a lack of interest and a greater risk exposure to cardiovascular complications associated with oral health

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

Association between C-Reactive protein and metabolic Syndrome in the Peruvian population of the Peru Migrant study

Introducción: El síndrome metabólico (MetS) es un grupo de factores de riesgo cardiovascular que se caracteriza por la presencia de inflamación crónica de bajo grado. Entre todos los biomarcadores inflamatorios asociados al MetS, el mejor caracterizado y bien estandarizado es la proteína C-Reactiva (PCR). Objetivo: Evaluar la asociación entre la proteína C-Reactiva y el síndrome metabólico en la población peruana del estudio PERU MIGRANT. Métodos: Estudio transversal analítico. Análisis de base de datos secundario del estudio PERU MIGRANT. Se consideró MetS según los criterios de Harmonizing the Metabolic Syndrome. Para la PCR, se dispuso un punto de corte ≥ 3 mg/L. Se usó modelos lineales generalizados de familia de Poisson para hallar la razón de prevalencias cruda y ajustada. Resultados: Se trabajó con un total de 958 sujetos. La prevalencia de MetS fue de 24,53%. En el análisis de regresión simple, se encontró que las personas con niveles altos de PCR tenían 75% mayor frecuencia de tener MetS, en comparación a quienes no presentaban niveles altos de PCR (RP=2,21, IC95%: 1,40 – 2,18). En la regresión múltiple, se observó que los pacientes con niveles altos de PCR tenían 31% mayor frecuencia de tener MetS, respecto a quienes presentaban niveles normales de PCR; ajustando por el resto de covariables (RP=1,31, IC95%: 1,05 – 1,62). Conclusiones: La PCR plasmática se asoció positivamente con MetS. Ello sugiere que un proceso inflamatorio de bajo grado puede estar relacionado con la presencia de MetS.Introduction: Metabolic syndrome (MetS) is a group of cardiovascular risk factors characterized by the presence of low-grade chronic inflammation. Among all the inflammatory biomarkers associated with MetS, the best characterized and well standardized is C-Reactive protein (CRP). Objectives: To evaluate the association between C-Reactive protein and metabolic syndrome in the Peruvian population of the PERU MIGRANT study. Methods: Secondary database analysis of the PERU MIGRANT study. MetS was considered according to the Harmonizing the Metabolic Syndrome criteria. For CRP, a cutoff point of ≥ 3 mg/L was established. Results: We worked with a total of 958 subjects. The prevalence of MetS was 24.53%. In the simple regression analysis, it was found that people with high CRP levels had a 75% higher frequency of having MetS, compared to those who did not present high CRP levels (PR = 2.21, 95% CI: 1.40 - 2.18). In multiple regression, it was observed that patients with high CRP levels had a 31% greater frequency of having MetS, compared to those with normal CRP levels; adjusting for the rest of the covariates (PR = 1.31, 95% CI: 1.05 - 1.62). Conclusions: Plasma CRP was positively associated with MetS. This suggests that a low-grade inflammatory process may be related to the presence of MetS. Against this, physicians should pay attention to glucose, lipid profile, and central obesity in patients with elevated plasma CRP levels.Campus Lima Nort

Factors Associated with Normal-Weight Abdominal Obesity Phenotype in a Representative Sample of the Peruvian Population: A 4-Year Pooled Cross-Sectional Study

To examine factors associated with abdominal obesity among normal-weight individuals from the Demographic and Health Survey of Peru (2018–2021). Cross-sectional analytical study. The outcome variable was abdominal obesity defined according to JIS criteria. Crude (cPR) and adjusted prevalence ratios (aPR) were estimated for the association between sociodemographic and health-related variables and abdominal obesity using the GLM Poisson distribution with robust variance estimates. A total of 32,109 subjects were included. The prevalence of abdominal obesity was 26.7%. The multivariate analysis showed a statistically significant association between abdominal obesity and female sex (aPR: 11.16; 95% CI 10.43–11.94); categorized age 35 to 59 (aPR: 1.71; 95% CI 1.65–1.78); 60 to 69 (aPR: 1.91; 95% CI 1.81–2.02); and 70 or older(aPR: 1.99; 95% CI 1.87–2.10); survey year 2019 (aPR: 1.22; 95% CI 1.15–1.28); 2020 (aPR: 1.17; 95% CI 1.11–1.24); and 2021 (aPR: 1.12; 95% CI 1.06–1.18); living in Andean region (aPR: 0.91; 95% CI 0.86–0.95); wealth index poor (aPR: 1.26; 95% CI 1.18–1.35); middle (aPR: 1.17; 95% CI 1.08–1.26); rich (aPR: 1.26; 95% CI 1.17–1.36); and richest (aPR: 1.25; 95% CI 1.16–1.36); depressive symptoms (aPR: 0.95; 95% CI 0.92–0.98); history of hypertension (aPR: 1.08; 95% CI 1.03–1.13), type 2 diabetes (aPR: 1.13; 95% CI 1.07–1.20); and fruit intake 3 or more servings/day (aPR: 0.92; 95% CI 0.89–0.96). Female sex, older ages, and low and high income levels increased the prevalence ratio for abdominal obesity, while depressive symptoms

Validación de escala de cambios en los estilos de vida durante el periodo de cuarentena en una población de estudiantes universitarios de Lima, Perú: Validation of scale of changes in lifestyles during the quarantine period in a population of university students from Lima, Peru

Introduction: Due to the presence of Covid-19 in the world, several countries, including Peru, have taken measures, including compulsory social isolation (quarantine). The inability of people to carry out their daily activities has directly affected their lifestyles. A population quite susceptible to these changes are university students. Objectives: To develop a validation scale to know what are the changes in lifestyles during the quarantine period in a population of university students from Lima, Peru. Results: The final scale was made up of 25 items. Bartlett's sphericity test was significant (3514.19, gl = 300, p <0.001) and the Kaiser-Meyer-Olkin sample size adequacy indicator was adequate (0.845). The four thematic areas were changes with respect to 1) Eating habits; 2) Harmful habits; 3) Physical activity; and 4) Use of communication media. As it was a Likert-type ordinal measurement scale, the results were confirmed through the Factor Analysys program, obtaining a KMO of 0.80 (reliable) and the significant Bartlett sphericity test (5528.8; p <0.001; gl = 300). confirming the existence of 7 components that explain 63% of the variance. Conclusions: This scale gathers the psychometric properties to be considered a useful, valid and reliable instrument to measure these changes in students of health science careers, being necessary to validate it prospectively in other careers and countries.Introducción: Debido a la presencia del Covid-19 en el mundo, varios países, entre ellos el Perú, ha tomado medidas, entre ellas el aislamiento social obligatorio (cuarentena). La imposibilidad de las personas para realizar sus actividades cotidianas ha repercutido directamente sobre sus estilos de vida. Una población bastante susceptible a estos cambios son los estudiantes universitarios. Objetivos: Desarrollar una escala de validación para conocer cuáles son los cambios en los estilos de vida durante el periodo de cuarentena en una población de estudiantes universitarios de Lima, Perú. Resultados: La escala final quedó conformada por 25 reactivos. La prueba de esfericidad de Bartlett fue significativa (3514.19, gl= 300, p<0.001) y el indicador de adecuación del tamaño de muestra Kaiser-Meyer-Olkin fue adecuado (0.845). Las cuatro áreas temáticas fueron camios con respecto a 1) Hábitos alimenticios; 2) Hábitos nocivos; 3) Actividad física; y 4) Uso de medios de comunicación. Al ser una escala de medición ordinal tipo Likert, se procedió a confirmar los resultados a través del programa Factor Analisys obteniendo un KMO de 0.80 (confiable) y la prueba de esfericidad de Bartlett significativa (5528.8; p<0.001; gl=300), confirmando la existencia de 7 componentes que explican el 63% de la varianza. Conclusiones: Esta escala reúne las propiedades psicométricas para ser considerado un instrumento útil, valido y fiable para medir dichos cambios en estudiantes de carreras de ciencias de la salud, siendo necesario validarlo en forma prospectiva en otras carreras y países

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

Combinaciones de síndrome metabólico y riesgo de diabetes mellitus

Introducción: El síndrome metabólico se asocia con un mayor riesgo de padecer diabetes, por lo que su identificación clínica ayuda a identificar a estos pacientes con alto riesgo. Objetivo: Determinar las combinaciones de síndrome metabólico para el riesgo de diabetes mellitus tipo 2 en una muestra de pobladores peruanos. Métodos: Análisis secundario de un estudio de cohorte de 5 años, de la base de datos del estudio PERU MIGRANT. Los componentes alterados del síndrome metabólico fueron lipoproteínas de alta densidad bajo, hipertrigliceridemia; glucosa, presión arterial y cintura abdominal elevadas. En total 35 subgrupos de componentes: 5 grupos para cada uno de los 5 componentes, 10 grupos de combinaciones de 2 componentes y 3 componentes, 5 grupos para la combinación de 4 componentes. Resultados: En el análisis de regresión múltiple, la glucosa como factor independiente presentó un RR estadísticamente significativo (RR= 9,02; IC: 95 % 2,45 - 33,24; p= 0,001). La combinación de 2 factores, presentaron un RR estadísticamente significativo, la glucosa - cintura abdominal (RR= 7,28; IC: 95 % 1,21 - 43,64; p= 0,030) y glucosa - alta densidad bajo (RR= 10,94; IC: 95 % 2,71 - 44,23; p= 0,001). Finalmente, la combinación de glucosa - lipoproteínas de alta densidad - cintura abdominal tenían 7,80 veces el riesgo de presentar diabetes mellitus tipo 2 versus quienes no lo presentaban (RP= 7,80; IC: 95 % 1,39 - 43,77; p= 0,020). Conclusión: Las combinaciones que incluyen al mismo tiempo glucosa - lipoproteínas de alta densidad - cintura abdominal, fueron las combinaciones que más asociaron.Campus Lima Nort

Hearing loss due to noise exposure and its relationship with hypertension in Peruvian workers

Introduction:Noise-induced hearing loss has been implicated in the genesis of several chronic conditions; however, its behavior concerning hypertension still raises doubts about it.Objective:to determine the association between hearing loss due to exposure to noise and the presence of hypertension in a sample of Peruvian workers.Methods: Cross-sectional analytical study. Secondary analysis of the occupational database of a Medical centerin Lima, Peru. hypertensionwas measured by self-report and clinical method. Hearing loss was classified as none, mild, moderate and severe. For the regression analysis, Poisson was performed with robust variance, obtaining crude (PRc) and adjusted (PRa) prevalence ratios.Results: We worked with a total of 1987 participants. The prevalence of hypertension was 15.40% and hearing loss was 36.39%. For the multivariate regression analysis, a statistically significant association with hypertension was found in those with mild hearing loss (PRa=1.52; CI95% 1.06–2.10), moderate (PRa=2.70; CI95% 1,93–3.76) and severe (PRa=3.82; 95% CI 2.56–5.96), compared to those without hearing loss.Conclusions:Hearing loss due to exposure to occupational noise was associated with the presence of hypertension. Although this study is only a first overview of the relationship that both variables could have, it is recommended to continue promoting policies and awareness campaigns to prevent hearing loss in workers, and thus avoid complications related to it in the long term.Campus Lima Nort

Hearing Loss due to Noise Exposure and its Relationship with Hypertension in Peruvian Workers

Introduction: Noise-induced hearing loss has been implicated in the genesis of several chronic conditions; however, its behavior concerning hypertension still raises doubts about it. Objective: to determine the association between hearing loss due to exposure to noise and the presence of hypertension in a sample of Peruvian workers. Methods: Cross-sectional analytical study. Secondary analysis of the occupational database of a Medical center in Lima, Peru. hypertension was measured by self-report and clinical method. Hearing loss was classified as none, mild, moderate and severe. For the regression analysis, Poisson was performed with robust variance, obtaining crude (PRc) and adjusted (PRa) prevalence ratios. Results: We worked with a total of 1987 participants. The prevalence of hypertension was 15.40% and hearing loss was 36.39%. For the multivariate regression analysis, a statistically significant association with hypertension was found in those with mild hearing loss (PRa=1.52; CI95% 1.06–2.10), moderate (PRa=2.70; CI95% 1,93–3.76) and severe (PRa=3.82; 95% CI 2.56–5.96), compared to those without hearing loss. Conclusions: Hearing loss due to exposure to occupational noise was associated with the presence of hypertension. Although this study is only a first overview of the relationship that both variables could have, it is recommended to continue promoting policies and awareness campaigns to prevent hearing loss in workers, and thus avoid complications related to it in the long term