Mountain sickness in altitude inhabitants of Latin America: A systematic review and meta-analysis.

OBJECTIVE: Chronic and acute mountain sickness is known worldwide, but most of the available information comes from the eastern continent (Himalayas) without taking into account the west which has the most recent group located at altitude, the Andes. The aim of this study was to synthesize the evidence on the prevalence of acute and chronic mountain sickness in Latin American countries (LATAM). METHODS: A systematic search of the variables of interest was performed until July 8, 2023 in the Web of Science, Scopus, PubMed and Embase databases. We included studies that assessed the prevalence of mountain sickness in high-altitude inhabitants (>1500 m.a.s.l) who lived in a place more than 12 months. These were analyzed by means of a meta-analysis of proportions. To assess sources of heterogeneity, subgroup analyses and sensitivity analyses were performed by including only studies with low risk of bias and excluding extreme values (0 or 10,000 ratio). PROSPERO (CRD42021286504). RESULTS: Thirty-nine cross-sectional studies (10,549 participants) met the inclusion criteria. We identified 5 334 and 2 945 events out of 10,000 with acute and chronic mountain sickness in LATAM countries. The most common physiological alteration was polycythemia (2,558 events), while cerebral edema was the less common (46 events). Clinical conditions were more prevalent at high altitudes for both types of MS. CONCLUSION: Acute mountain sickness (AMS) occurs approximately in 5 out of 10 people at high altitude, while chronic mountain sickness (CMS) occurs in 3 out of 10. The most frequent physiological alteration was polycythemia and the least frequent was cerebral edema.

Incidence of hypopituitarism in adults undergoing radiotherapy for neck and head cancer: protocol for a systematic review and meta-analysis.

INTRODUCTION: When children with head and neck cancer receive radiation therapy as part of their treatment, a considerable frequency of hypopituitarism has been recognised. However, in adults, it has been little studied and it is possible that patients may be inadvertently affected. The objective is to estimate the incidence of anterior pituitary dysfunction in adults undergoing radiotherapy for head and neck cancer. METHODS AND ANALYSIS: A total of five databases will be used to perform the document search: PubMed, Scopus, Web of Science (Core Collection), Ovid-MEDLINE and Embase. Cohort studies will be included without restriction by language or date. The main outcome will be the incidence of adenohypophyseal dysfunction for each axis: prolactin, growth hormone, thyroid-stimulating hormone, adrenocorticotropic hormone, luteinising hormone and follicle-stimulating hormone. Incidence meta-analysis will be performed using the Freeman-Tukey double arcsine method. In addition, a random-effects model will be used along with a 95% CI. Subgroup analyses will be performed according to tumour location, radiation dose and endocrine assessment time. Meta-regression will be applied according to patient's age and time elapsed until diagnosis. ETHICS AND DISCLOSURE: Since this will be a systematic review of published data, no ethics committee approval is required. The results will be presented at conferences and finally published in a peer-reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021235163.

What is known about osteoporosis research in Latin America?: A bibliometric analysis of three decades.

Identifying the gaps in scientific production in a topic allows directing research in order to make better public investment decisions. Bibliometric data on osteoporosis in Latin America are very limited and unclear and, given the impact of this disease in this region, it is relevant to analyze the latest trends in the subject. The study approach was quantitative, observational-descriptive, cross-sectional. Data were collected from journals indexed in Scopus between 1990 and 2019, using a search strategy that included Medical Subject Headings terms for "Osteoporosis" and other related terms, as well as VOSviewer software to create cooperative and co-occurrence word maps. 3261 documents were analyzed, with an annual scientific production rate of 5% (163 documents), where 73.9% were original articles. The countries with the highest scientific production in osteoporosis were Brazil (55.2%) and Argentina (18%). Extra-regional cooperation was mainly with the United States (16.35%) and Spain (5.18%). Six of the 10 most productive countries had their own government agencies as the main funders. The National Council for Scientific and Technological Development was the institution that funded the most (n = 194). The term "osteoporosis" together with the terms "bone mineral density," "fractures," and "menopause" were the most frequently addressed subjects. Latin American scientific production in osteoporosis has shown a significant increase. However, in the last 3 years it has shown a slight reduction. Greater intraregional collaboration involving universities, institutions and health societies is needed.

Cluster Analysis of Factors Associated with Leishmaniasis in Peru.

OBJECTIVE: To analyze the factors associated with leishmaniasis in Peru, according to the cluster classification in the period 2017-2021. METHODS: Quantitative approach, with an ecological, descriptive correlational, and cross-sectional design. The population was from the geographical region of Peru, where a total of 26,956 cases of leishmaniasis were registered by the Peruvian Ministry of Health from 2017 to 2021. Spearman's Rho statistic was used to analyze the variables that are most associated with the cases of leishmaniasis reported per year, and, in addition, the multivariate technique of cluster analysis was applied. RESULTS: Annual rainfall and areas with humid forest (climatic factors) and mortality from transmissible diseases (health factor) are directly associated with reported cases of leishmaniasis. Households with basic access to infrastructure, drinking water, drainage, and electric lighting; illiteracy, regional social progress, and unsatisfied basic needs (social factors); and percentage of urban population (demographic factor) are inversely and significantly associated with cases of leishmaniasis. CONCLUSIONS: Climatic and environmental factors contribute to the multiplication of the leishmaniasis disease vector. The incidence of leishmaniasis adds up to the mortality rates for transmissible diseases in Peru. As living conditions improve, the incidence of this pathology decreases.

Validity and Reliability of the Knowledge, Attitudes and Practices Instrument Regarding Monkey Pox in Peru.

Objective: To analyze the questionnaire of the validity and reliability of knowledge, attitudes and practices concerning Mpox. Methods: This was an instrumental, cross-sectional study. The sample consisted of 178 citizens from 3 sectors of Peru, who responded to a virtual questionnaire regarding knowledge, attitudes and practices concerning Mpox. The validity and reliability process of the questionnaire was carried out using Aiken's V, Cronbach's Alpha, McDonald's Omega and principal component analysis. Results: After expert evaluation, the questionnaire was shown to have adequate content validity for measuring knowledge, attitudes and practices concerning Mpox, each in their respective dimensions, with Aiken's V values above 0.90. For construct validity, exploratory factor analysis was used and the items were grouped into four dimensions for the level of knowledge, three dimensions for attitudes, and two for practices. With respect to the reliability analysis, the application of Cronbach's α statistic and McDonald's ω, obtained values above 0.70. Conclusion: The results of the research enabled the attainment of a questionnaire that meets the adequate psychometric characteristics in order to be applied.

Factors Associated with the Acceptance of COVID-19 Vaccines in Citizens of Northern Peru: Cross-Sectional Study.

Purpose: The presence of the COVID-19 coronavirus in Peru, and especially in northern Peru, was very fast and caused many deaths. As a result, vaccination proved to be the most immediate option to control it. However, a sector of the population was reluctant to vaccination. Therefore, this study aimed to analyze the factors associated with the acceptance of COVID-19 vaccines by citizens of northern Peru. Patients and Methods: The study was observational, descriptive-correlational and the sample was stratified and consisted of 516 citizens from eight departments of northern Peru, who answered an online questionnaire regarding sociodemographic, cultural and health aspects. The data were analyzed using statistical tests of association and a logistic model was estimated to identify factors predicting vaccine acceptance. Results: Among the factors associated with vaccine acceptance, sociodemographic factors such as age and family income, cultural factors such as level of knowledge, and health factors such as having another chronic disease and a vaccine with a higher confidence (p<0.05) were found. In addition, 12% of the population do not trust them, 10% are afraid that they may cause thrombosis, 13% disagree with vaccination for children, 7% think that a chip will be implanted and 8% believe that their DNA will be changed. However, most people accept vaccination and consider it necessary. A multivariate analysis was also performed for the acceptance of vaccines, which presented a percentage of 80.2% correct in the prognosis. Conclusion: The multivariate analysis allowed a conclusion that the predictor variables for vaccine acceptance are household income of less than 1000 Peruvian soles per month, low or medium levels of knowledge, and having another chronic disease.

Adherence to literature search reporting guidelines in leading rheumatology journals' systematic reviews: umbrella review protocol.

Literature searches are important components of systematic reviews. They are not only informative of the retrieval process, but they also set the data to be analyzed and influence additional components of systematic reviews. Despite the available guidelines, several studies have shown that the quality of reporting in systematic reviews is deficient in several medical fields. Systematic reviews may not comply completely with those guidelines despite explicitly stating they do. This protocol intends to answer to what extent systematic reviews published in rheumatology journals have complied with the PRISMA's search strategy guidelines published in 2009. The objective of the study is to analyze the compliance with the PRISMA (2009) search strategy guidelines among systematic reviews published in leading rheumatology journals. Inclusion criteria for this umbrella review protocol are systematic reviews (with or without meta-analyses) that mention having followed the PRISMA statement (2009) in their methods section, and published in journals listed in the Rheumatology category of the Journal of Citations Report 2020. Exclusion criteria are articles published before 2009; retraction letters, notes, expressions of concern; systematic reviews using PRISMA 2020. Databases to be consulted are Web of Science, PubMed and Scopus, from inception to present. Data summaries will be presented in graphs, figures, tables and network maps. A narrative synthesis will be described. This protocol complies with guidelines such as PRISMA 2020, PRISMA-A, PRISMA-P, PRISMA-S, PRESS, and JBI Manual for evidence synthesis, as long as it is suitable for umbrella review protocols. Articles in any language will be considered.

Factores maternos asociados a prematuridad en gestantes de un hospital público de Trujillo, Perú

Introducción: El riesgo de prematuridad abarca una amplia variedad de complicaciones al nacer, como enfermedades infecciosas, hemorragia intraventricular, deficiencias neurosensoriales, insuficiencia respiratoria y afectación de otros sistemas, así como problemas de crecimiento y desarrollo. Por tanto, la consecución del Objetivo de Desarrollo del Milenio de reducir la mortalidad infantil, depende en gran medida de la reducción de la mortalidad relacionada con el nacimiento prematuro, lo que lo convierte en uno de los desafíos más importantes para la salud pública moderna. Objetivo: Identificar los factores maternos asociados a prematuridad. Material y Métodos: Se realizó un estudio de tipo caso-control retrospectivo en 2000 recién nacidos vivos de un hospital público de Trujillo, entre el 2015-2019. Se dividieron los grupos según el criterio de edad gestacional. Se analizaron las variables clínicas maternas pareadas según prematuridad o a término, y se realizó un análisis bivariado y multivariado por regresión logística ajustada por confusores. Resultados: Se demostró que el número de controles prenatales menor a cuatro durante la gestación, está asociado a prematuridad (OR 2,65; IC95%: 2,21-3,18). Por otro lado, la ausencia de una infección del tracto urinario (OR 0,73; IC95%: 0,56-0,95), está asociado a menor riesgo de prematuridad. Conclusiones: El número de controles prenatales es un factor asociado importante para parto prematuro, mientras que la ausencia de una ITU puede estar asociada a menor tasa de partos prematuros en gestantes de riesgo.

Factors associated with COVID-19 in people with Parkinson's disease: a systematic review and meta-analysis.

BACKGROUND: There is debate as to whether there is an increased risk of COVID-19 infection in people with Parkinson's disease (PD), possibly due to associated factors. This study aimed to systematically review the factors associated with COVID-19 in people with PD. METHODS: A search was carried out in PubMed, Scopus, and Web of Science up to November 2020 (updated until 1 April 2021). Observational studies that analyzed factors associated with COVID-19 in people with PD were selected and revised. RESULTS: The authors included six studies (four case-controlled studies and two cross-sectional studies) in the qualitative and quantitative syntheses. The authors found that the following factors were associated with COVID-19 in people with PD: obesity (OR: 1.79, 95% CI: 1.07-2.99, I2 : 0%), any pulmonary disease (OR: 1.92, 95% CI: 1.17-3.15, I2 : 0%), COVID-19 contact (OR: 41.77, 95% CI: 4.77 - 365.56, I2 : 0%), vitamin D supplementation (OR: 0.50, 95% CI: 0.30-0.83, I2 : 0%), hospitalization (OR: 11.78, 95% CI: 6.27-22.12, I2 : 0%), and death (OR: 11.23, 95% CI: 3.92-32.18, I2 : 0%). The authors did not find any significant association between COVID-19 and hypertension, diabetes, cardiopathy, cancer, any cognitive problem, dementia, chronic obstructive pulmonary disease, renal or hepatic disease, smoking, and tremor. CONCLUSIONS: Meta-analyses were limited by the number of events and some methodological limitations. Despite this, the authors assessed the available evidence, and the results may be useful for future health policies.

Latin American Research on Bariatric Surgery: a Bibliometric Study.

We performed a bibliometric analysis of Latin American documents published between 1984 to 2019 in Scopus-indexed journals. A total of 1856 documents were analyzed. The annual scientific production was 64 documents per year, with an annual increase rate of 15.9%. The countries with the highest scientific production on BS were Brazil (64.7%) and Chile (14.5%). Most of the publications were original (76.6%) and review articles (11.9%). The journal with the highest publication record was "Obesity Surgery" (25.8%). The extra-regional collaboration was mainly with the USA. In conclusion, Latin American scientific production on BS has shown a significant increase in recent years. However, more participation is needed, fostering intra-regional collaboration and involving universities and health institutions in BS research.

Impacto del COVID-19 en la educación de los estudiantes de medicina del Perú / Impact Of COVID-19 On The Education Of Medical Students In Peru

La pandemia por el coronavirus del Síndrome Respiratorio Agudo Grave 2 (SARS-CoV-2) que causa la enfermedad Coronavirus 2019 (COVID-19), es una enfermedad altamente contagiosa que representa una emergencia a nivel mundial. Al 22 de mayo del 2020 se cuenta con 4 993 470 casos confirmados y 327738 muertes entre 188 países/regiones, al mismo tiempo en Perú ya existen 111 698 casos positivos y 3244 fallecidos; datos que seguirán extendiéndose y poniendo en peligro la vida de miles de personas, afectando a estados, municipios e instituciones públicas y privadas; en tal sentido, se están tomando medidas más estrictas en el manejo de la cuarentena, aislamiento y distanciamiento social obligatorio, lo que repercute directamente en todas las actividades que involucren las reuniones presenciales.

The pandemic caused by Severe Acute Respiratory Syndrome 2 (SARS-CoV-2) caused by the Coronavirus disease 2019 (COVID-19) is a highly contagious disease that represents an emergency worldwide. On May 22, 2020 we counted 4,993,470 confirmed cases and 327,738 deaths among 188 countries/regions, at the same time there already existed 111,698 positive cases and 3,244 deaths in Peru already existed; data that will continue to expand and that places thousands of lives in danger, affecting states, municipalities and public and private institutions. In that regard, stricter measures are being taken with the obligatory quarantine, isolation and social distancing management, which directly affects all activities that involve in person gatherings.