Sjogren\u27s Syndrome: Relationship Between Ocular Findings and Parotid Sialograms

This study evaluates the incidence and severity of the ocular findings and its correlation with the parotid gland changes, as demonstrated by sialography, in 82 patients with Sjogren\u27s syndrome. It is shown that the ocular component of the syndrome manifests rather autonomously with respect to the accompanying collagen disease and that there seems to be only a tentative trend towards a positive correlation between the ocular and parotid findings. Sjogren\u27s syndrome immunologically is closer to the collagen diseases than to the so-called organ-specific autoimmune diseases

Introduccion y difusion de un nuevo manejo integrado de plagas de la papa en la sierra central del Peru.

La papa (Solanum tuberosum L.) es cultivada en diversos agro ecosistemas de la región andina y presenta diferentes plagas de insectos necesitándose contar con soluciones específicas de control. Hemos desarrollado estrategias de Manejo Integrado de Plagas (MIP) para los sistemas de producción en los Andes peruanos. Se han considerado las plagas de importancia económica y desarrollado innovaciones tecnológicas para reemplazar, con igual eficacia, las aplicaciones de los insecticidas. Basados en las prácticas culturales, el nuevo MIP se compone de las siguientes nuevas tecnologías y estrategias: (i) impedir la migración del gorgojo de los Andes (Premnotrypes spp.) en los campos de papa mediante el uso de barreras de plástico, (ii) monitorear la presencia de Epitrix spp. y eventualmente realizar una sola aplicación de insecticidas de baja toxicidad y (iii) aplicar atracticidas, una tecnología que consiste en una co-formulación de feromona con insecticida, en la pre-floración para reducir la infestación de los tubérculos por las polillas de la papa [Phthorimaea operculella (Zeller), Symmetrischema tangolias (Gyen.)]. Para el control de las polillas en almacén se utiliza el talco-Btk, una formulación de Bacillus thuringiensis kurstaki o atracticidas. Este nuevo diseño del MIP presenta importantes ventajas económicas y ecológicas en los lugares piloto. Por otra parte, se debe incrementar la capacidad de recuperación de los agro ecosistemas a través de adecuadas estrategias de aumento de los enemigos naturales en campo (p.ej. a través del incremento de la diversidad vegetal, bordes, cultivos asociados o policultivos) y el control biológico inoculativo para recuperar aquellas especies que se han perdido por el uso intensivo de insecticidas. Se ha iniciado la capacitación en MIP en el valle del Mantaro y las nuevas tecnologías han sido bien aceptadas por los extensionistas y los agricultores, particularmente los productores orgánicos de papa. Una alta adopción de la propuesta del nuevo MIP podría beneficiarse del costo-beneficio de las barreras de plástico. Se han establecido relaciones con el sector privado para introducir y que esté disponible el plástico en el tamaño y la calidad adecuada (40 cm de ancho), para la formulación, registro y comercialización del talco-Btk, un producto biológico de bajo costo, así como el registro del atrayente en el Perú. El principal factor limitante para la implementación del MIP en el Perú podría ser la fuerte competencia con los productos químicos, ya que los agricultores tienen fácil acceso a ellos a través de una sólida red de vendedores. Es importante el rol del gobierno para la regulación de los insecticidas altamente tóxicos y para la promoción más amplia del MIP

Umbrales: A Collection of Poetry in Spanish

De la nada, Mi reino, El encargo, Ser, and Desde mi ventana are the first five poems of an unpublished collection entitled Umbrales. These poems explore the dilemmas that human beings usually face, primarily, in the early stages of life. Finding yourself and questioning your willingness to break free from others’ expectations is at the core of “Umbrales”

Sensitivity and specificity of the Patient Health Questionnaire (PHQ-9, PHQ-8, PHQ-2) and General Anxiety Disorder scale (GAD-7, GAD-2) for depression and anxiety diagnosis: a cross-sectional study in a Peruvian hospital population

OBJECTIVES: The Patient Health Questionnaire (PHQ) and Generalised Anxiety Disorder Scale (GAD) are widely used screening tools, but their sensitivity and specificity in low-income and middle-income countries are lower than in high-income countries. We conducted a study to determine the sensitivity and specificity of different versions of these scales in a Peruvian hospital population. DESIGN: Our study has a cross-sectional design. SETTING: Our participants are hospitalised patients in a Peruvian hospital. The gold standard was a clinical psychiatric interview following ICD-10 criteria for depression (F32.0, F32.1, F32.2 and F32.3) and anxiety (F41.0 and F41.1). PARTICIPANTS: The sample included 1347 participants. A total of 334 participants (24.8%) were diagnosed with depression, and 28 participants (2.1%) were diagnosed with anxiety. RESULTS: The PHQ-9's≥7 cut-off point showed the highest simultaneous sensitivity and specificity when contrasted against a psychiatric diagnosis of depression. For a similar contrast against the gold standard, the other optimal cut-off points were: ≥7 for the PHQ-8 and ≥2 for the PHQ-2. In particular, the cut-off point ≥8 had good performance for GAD-7 with sensitivity and specificity, and cut-off point ≥10 had lower levels of sensitivity, but higher levels of specificity, compared with the cut-off point of ≥8. Also, we present the sensitivity and specificity values of each cut-off point in PHQ-9, PHQ-8, PHQ-2, GAD-7 and GAD-2. We confirmed the adequacy of a one-dimensional model for the PHQ-9, PHQ-8 and GAD-7, while all PHQ and GAD scales showed good reliability. CONCLUSIONS: The PHQ and GAD have adequate measurement properties in their different versions. We present specific cut-offs for each version

Resiliencia y Burnout en enfermeras de un hospital general de Lima, Perú

Background: The present study aimed to determine the relationship between resilience and burnout dimensions (emotional wear, indifference, and professional efficacy) in nurses of a general hospital in Metropolitan Lima. Method: 150 nurses were evaluated with the Maslach Burnout Inventory (MBI - GS) and with the Connor-Davidson Resilience Scale of 10 items (CD-RISC 10). The correlations between the variables were calculated and the scores were compared according to the types of shift and labor contract. . Results: There is a statistically significant relationship between resilience and burnout, being negative with the emotional stress and indifference dimensions, while with professional efficacy it was positive, obtaining small and moderate effect sizes. In addition, statistically significant differences and medium effect sizes in emotional stress and indifference were found according to the type of shift and employment contract. Conclusion: The resilience and dimensions of burnout have a significant relationship in nurses of a general hospital in Metropolitan Lima.Introducción: El presente estudio buscó determinar la relación entre la resiliencia y las dimensiones del burnout (desgaste emocional, indiferencia y eficacia profesional) en enfermeras de un hospital general de Lima Metropolitana. Método: Se evaluó a 150 enfermeras con el Inventario de Burnout de Maslach (MBI – GS) y con la Escala de Resiliencia de Connor-Davidson de 10 ítems (CD-RISC 10). Se calcularon las correlaciones entras las variables y se compararon las puntuaciones según los tipos de turno y de contrato laboral.Resultados: Existe una relación estadísticamente significativa entre la resiliencia y el burnout, siendo negativa con las dimensiones desgaste emocional e indiferencia, mientras que con la eficacia profesional fue positiva, obteniéndose tamaños del efecto pequeño y moderados. Además, se hallaron diferencias estadísticamente significativas y tamaños del efecto medianos en desgaste emocional e indiferencia según tipo de turno y contrato laboral. Conclusión: La resiliencia y las dimensiones del burnout tienen una relación significativa en enfermeras de un hospital general de Lima Metropolitana

Parents' Perceptions about Salt Consumption in Urban Areas of Peru: Formative Research for a Social Marketing Strategy.

BACKGROUND: Salt intakes in Latin America currently double the World Health Organization's recommendation of 5 g/day. Various strategies to reduce the population's salt consumption, such as raising awareness using social marketing, have been recommended. This study identified parents' perceptions of salt consumption to inform a social marketing strategy focused on urban areas in Peru. METHODS: Using a sequential exploratory methods design, parents of pre-school children, of high and low socioeconomic status, provided qualitative data in the form of interviews and focus groups. Following this, quantitative data was obtained via questionnaires, which were sent to all parents. The information was analyzed jointly. RESULTS: 296 people (mean age 35.4, 82% women) participated, 64 in the qualitative and 232 in the quantitative phase of the study. Qualitative data from the first phase revealed that the majority of mothers were in charge of cooking, and female participants expressed that cooking was "their duty" as housewives. The qualitative phase also revealed that despite the majority of the participants considered their salt intake as adequate, half of them mentioned that they have tried to reduce salt consumption, and the change in the flavor of the food was stated as the most difficult challenge to continue with such practice. Quantitative data showed that 67% of participants would be willing to reduce their salt intake, and 79.7% recognized that high salt intake causes hypertension. In total, 84% of participants reaffirmed that mothers were in charge of cooking. There were no salient differences in terms of responses provided by participants from high versus low socioeconomic groups. CONCLUSIONS: The results point towards the identification of women as a potential target-audience of a social marketing strategy to promote reductions in salt intake in their families and, therefore, a gender-responsive social marketing intervention is recommended

Thermal and current flow effects of a capacitive–resistive electric transfer application protocol on chronic elbow tendinopathy. A cadaveric study

Lateral elbow tendinopathy, or “tennis elbow”, is a pathology that affects around 1.3% of the general population. Capacitive–resistive electric transfer therapy aims to provoke temperature and current flow changes in superficial and deep tissues. The aim of this in vitro study was to analyze the thermal behavior and transmission of electric current on the superficial and deep tissues of the elbow during the application of different modalities of a capacitive–resistive electric transfer treatment protocol for chronic elbow tendinopathy. A cross-sectional study was designed; five fresh cryopreserved cadavers (10 elbows) were included in this study. A 30 min intervention was performed based on a protocol commonly used in clinics for the treatment of chronic lateral elbow tendinopathy by diathermy using the “T-Plus.” Common extensor tendon, radiohumeral capsule, and superficial temperatures were registered after each application for the duration of the 30 min treatment protocol. During all applications, we observed a current flow of over 0.03 A. The protocol showed a statistically significant increase in superficial temperature by 24% (5.02¿) (p < 0.005), the common extensor tendon by 19.7% (4.36¿) (p < 0.007), and the radiohumeral joint capsule by 17.5% (3.41¿) (p < 0.005) at the end of the 30 min protocol compared with the baseline temperature. The different applications of the protocol showed specific effects on the temperature and current flow in the common extensor tendon and radiohumeral capsule. All applications of the protocol produced a current flow that is associated with the generation of cell proliferation. These results strengthen the hypothesis of cell proliferation and thermal changes in deep and distal structures. More studies are needed to confirm these results