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OBJECTIVE: While statistical analysis plays a crucial role in medical science, some published studies might have utilized suboptimal analysis methods, potentially undermining the credibility of their findings. Critically appraising analytical approaches can help elevate the standard of evidence and ensure clinicians and other stakeholders have trustworthy results on which to base decisions. The aim of the present study was to examine the statistical characteristics of original articles published in Peruvian medical journals in 2021-2022. DESIGN AND SETTING: We performed a methodological study of articles published between 2021 and 2022 from nine medical journals indexed in SciELO-Peru, Scopus, and Medline. We included original articles that conducted analytical analyses (i.e., association between variables). The statistical variables assessed were: statistical software used for analysis, sample size, and statistical methods employed (measures of effect), controlling for confounders, and the method employed for confounder control or epidemiological approaches. RESULTS: We included 313 articles (ranging from 11 to 77 across journals), of which 67.7% were cross-sectional studies. While 90.7% of articles specified the statistical software used, 78.3% omitted details on sample size calculation. Descriptive and bivariate statistics were commonly employed, whereas measures of association were less common. Only 13.4% of articles (ranging from 0% to 39% across journals) presented measures of effect controlling for confounding and explained the criteria for selecting such confounders. CONCLUSION: This study revealed important statistical deficiencies within analytical studies published in Peruvian journals, including inadequate reporting of sample sizes, absence of measures of association and confounding control, and suboptimal explanations regarding the methodologies employed for adjusted analyses. These findings highlight the need for better statistical reporting and researcher-editor collaboration to improve the quality of research production and dissemination in Peruvian journals.
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Publicaciones Periódicas como Asunto , Perú , Publicaciones Periódicas como Asunto/estadística & datos numéricos , Humanos , Tamaño de la Muestra , Edición/estadística & datos numéricos , Proyectos de InvestigaciónRESUMEN
INTRODUCTION: Climate change (CC) is a global public health issue, and the role of health professionals in addressing its impact is crucial. However, to what extent health professionals are prepared to deal with CC-related health problems is unclear. We aimed to evaluate the knowledge, attitudes, and practices of health students about the CC. METHODS: We conducted a scoping review through systematic searches in PubMed, Scopus, Web of Science, Proquest, and EBSCO. We included original scientific research with no language or time restrictions. Two authors independently reviewed and decided on the eligibility of the studies, then performed data extraction. RESULTS: 21 studies were included, with a total of 9205 undergraduate nursing, medical, pharmacy, and public health students mainly. Most health science students (> 75%) recognized human activities as the main cause of CC. However, they perceived a lack of knowledge on how to address CC. Moreover, we found inadequate coverage or limited development of CC in related curricula that may contribute to incomplete learning or low confidence in the theoretical and practical concepts of students. CONCLUSION: The findings of our scoping review suggest that while health sciences students possess a general understanding of CC, there is a significant gap in their knowledge regarding its specific health impacts. To address this gap, there is a need for targeted education and training for future health care professionals that emphasizes the health effects of CC.
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Cambio Climático , Conocimientos, Actitudes y Práctica en Salud , Humanos , Curriculum , Estudiantes del Área de la Salud/psicologíaRESUMEN
Despite the well-known impact of depression on patients with chronic pain and its association, few studies have evaluated its related factors in Physical Medicine and Rehabilitation settings. The objective of the present study was to assess the factors associated with depression in adult patients undergoing rehabilitation for chronic pain at Hospital Rebagliati (HNERM) in Peru. A cross-sectional analytical study was conducted between June and August 2023, involving 212 adult patients with chronic pain undergoing rehabilitation at HNERM. Data were collected through a survey, including sociodemographic information, pain characteristics, and depression assessment using the Patient Health Questionnaire-9 (PHQ-9). Statistical analysis included descriptive statistics and generalized linear models to identify factors associated with depression. Among 212 participants, 17.9% had a depression diagnosis based on the PHQ-9 (cutoff score: 10 points). Factors associated with a higher frequency of depression included a time since pain diagnosis of 3-6 months [adjusted prevalence ratios (aPR): 1.15, 95% confidence interval (CI): 1.04-1.27], severe pain (aPR: 1.17, 95% CI: 1.04-1.32), comorbidities (for 1: aPR: 1.21, 95% CI: 1.08-1.35; for 2: aPR: 1.17, 95% CI: 1.06-1.29; for ≥3: aPR: 1.27, 95% CI: 1.10-1.47), use of ≥2 medications for pain management (aPR: 1.27, 95% CI: 1.13-1.42), and receipt of psychological therapy (aPR: 1.26, 95% CI: 1.09-1.46). Nonpharmacological interventions did not show an association with an increased prevalence of depression. These findings underscore the significance of adopting a comprehensive approach to chronic pain management, including the screening, assessment, and treatment of associated depression.
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Dolor Crónico , Humanos , Dolor Crónico/rehabilitación , Dolor Crónico/psicología , Estudios Transversales , Perú , Masculino , Femenino , Persona de Mediana Edad , Adulto , Depresión/epidemiología , AncianoRESUMEN
OBJECTIVE: To evaluate the association between GGT/HDL-C ratio and resolution of MetS in adults after sleeve gastrectomy (SG). METHODS: We conducted a retrospective cohort study using secondary data from a Peruvian bariatric center. The study population consisted of adults aged 18 and above who underwent laparoscopic SG and were diagnosed with MetS prior to the surgery. The main outcome measured was MetS resolution 6 months post-surgery and the exposure variable was the GGT/HDL-C ratio. RESULTS: We analyzed 137 patients with a mean age of 38.9 ± 10.9 years; 64.2% were females. The median GGT/HDL-C ratio was 1.1 [0.7 - 1.5], and 83.9% of patients experienced resolution of MetS. Furthermore, both the middle tertile of GGT/HDL-C (aRR: 1.28; 95% CI: 1.04 - 1.58; p = .019) and the lowest tertile (aRR: 1.27; 95% CI: 1.01 - 1.60; p = .038) showed a significant association with the resolution of MetS. CONCLUSION: Eight out of 10 patients undergoing SG experience resolution of MetS within 6 months after surgery. Patients in the middle and lower tertiles of the GGT/HDL-C were more likely to achieve this outcome. Therefore, the GGT/HDL-C ratio should be considered a valuable and efficient biomarker for preoperative assessment of bariatric surgery candidates.
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Biomarcadores , HDL-Colesterol , Gastrectomía , Síndrome Metabólico , gamma-Glutamiltransferasa , Humanos , Femenino , Adulto , Masculino , Estudios Retrospectivos , Síndrome Metabólico/sangre , Síndrome Metabólico/diagnóstico , Persona de Mediana Edad , Biomarcadores/sangre , HDL-Colesterol/sangre , Resultado del Tratamiento , gamma-Glutamiltransferasa/sangre , Factores de Tiempo , Gastrectomía/efectos adversos , Perú , Valor Predictivo de las Pruebas , Obesidad Mórbida/cirugía , Obesidad Mórbida/sangre , Obesidad Mórbida/complicaciones , Inducción de Remisión , Pérdida de Peso , Laparoscopía/efectos adversos , Factores de Riesgo , Cirugía Bariátrica/efectos adversosRESUMEN
OBJECTIVE.: Motivation for the study. Despite the prevalence of ASD, research in the field of Physical Medicine and Rehabilitation is scarce in Peru. Main findings. Of 120 children with a previous diagnosis of ASD, only 9.8% received inclusive education. The median age at diagnosis was 3.83 years. We also found that 78.4% had no disability certificate and 77.5% had incomplete psychological evaluation. The median time since the last physical, occupational, and speech therapy sessions was 3 months, 8 months, and 3.5 months, respectively. Implications. These findings highlight the need to enhance early diagnosis, inclusive education, and evaluation and subsequent certification of disability, as well as to establish more timely interventions. Autism spectrum disorder (ASD) is characterized by developmental disorders, difficulties in social interaction and communication, and restrictive and repetitive patterns of behavior. Despite its high prevalence, few studies have been conducted in rehabilitation settings. This study aimed to describe the characteristics of children with ASD from the Pediatric Rehabilitation Service of the Rebagliati Hospital (SRP-HNERM). MATERIALS AND METHODS.: Cross-sectional descriptive study. We reviewed the medical records of children under 14 years of age previously diagnosed with ASD from the SRP-HNERM during 2022. RESULTS.: A total of 120 children with ASD were evaluated. The median age was 5 years. Most received regular education, but it was inclusive only for 9.8%. The mean age at diagnosis was 3.83 years. We found that 78.4% had no disability certificate and 77.5% of the participants had incomplete psychological evaluation. The median time since the last physical, occupational and speech therapy sessions was 3, 8 and 3.5 months respectively. CONCLUSION.: The mean age at diagnosis of ASD was older than three years, and more than 75% of the patients had neither a disability certificate nor a complete psychological evaluation. The median time since the last rehabilitation therapy sessions was three months or more. Our findings highlight the need to improve early diagnosis, inclusive education and evaluation and subsequent certification of disability, as well as to establish timely interventions.
OBJETIVO.: Motivación para realizar el estudio. A pesar de la prevalencia del trastorno del espectro autista (TEA), la investigación en el campo de la Medicina Física y Rehabilitación es escasa en Perú. Principales hallazgos. De 120 niños con diagnóstico previo de TEA evaluados, solo el 9,8% recibió educación inclusiva. La media de edad de diagnóstico fue de 3,83 años. El 78,4% no tenía certificado de discapacidad y el 77,5% tenía evaluación psicológica incompleta. La mediana del tiempo transcurrido desde las últimas sesiones de terapia física, ocupacional y de lenguaje fue de 3 meses, 8 meses y 3,5 meses, respectivamente. Implicancias. Estos hallazgos resaltan la necesidad de potenciar el diagnóstico temprano, la educación inclusiva y la evaluación y posterior certificación de la discapacidad, así como de establecer intervenciones más oportunas. El trastorno del espectro autista (TEA) se caracteriza por alteraciones en el desarrollo, dificultades de interacción social y comunicación, y patrones restrictivos y repetitivos de conducta. A pesar de su alta prevalencia, pocos estudios se han realizado en ambientes de rehabilitación. El objetivo del estudio fue describir las características de los niños con TEA atendidos en el Servicio de Rehabilitación Pediátrica del Hospital Rebagliati (SRP-HNERM). MATERIALES Y MÉTODOS.: Estudio descriptivo transversal. Se revisaron las historias clínicas de niños menores de 14 años con diagnóstico previo de TEA atendidos en el SRP-HNERM durante el 2022. RESULTADOS.: Se evaluaron a 120 niños con TEA. La mediana de edad fue de cinco años. La mayoría recibía educación regular, pero solo para el 9,8% fue inclusiva. La media de edad de diagnóstico fue de 3,83 años. El 78,4% no tenía certificado de discapacidad y el 77,5% tenía evaluación psicológica incompleta. La mediana del tiempo transcurrido desde las últimas sesiones de terapia física, ocupacional y de lenguaje fue de 3, 8 y 3,5 meses respectivamente. CONCLUSIÓN.: La media de edad de diagnóstico de TEA fue mayor de tres años y más del 75% de los pacientes no contaban con un certificado de discapacidad ni con una evaluación psicológica completa. La mediana del tiempo desde las últimas sesiones de terapias de rehabilitación fue de tres meses o más. Estos hallazgos resaltan la necesidad de potenciar el diagnóstico temprano, la educación inclusiva y la evaluación y posterior certificación de la discapacidad, así como de establecer intervenciones más oportunas.
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Trastorno del Espectro Autista , Humanos , Trastorno del Espectro Autista/rehabilitación , Perú , Preescolar , Masculino , Femenino , Estudios Transversales , Niño , Adolescente , Lactante , Derivación y ConsultaRESUMEN
OBJECTIVES.: Motivation for the study. No study conclusively recommends the use of medicinal plants to treat COVID-19 symptoms, and their indiscriminate use may present health risks. Main findings. Sixty percent of participants consumed medicinal plants to prevent COVID-19. This was particularly true for those living in the Peruvian highlands and individuals with family members diagnosed or deceased from COVID-19, who perceive a higher risk of infection and use medications or chlorine dioxide as preventive measures. Implications. Communication strategies emphasizing validated preventive practices and educating about the risks of consuming medicinal plants should be tailored to the predominant characteristics of the consumer. Determine the factors associated with the consumption of medicinal plants as a preventive measure against COVID-19 in the Peruvian population. MATERIALS AND METHODS.: A population over 18 years of age, living in Peru and without a history of COVID-19 disease, was evaluated. The factors associated with the consumption of medicinal plants were evaluated using a Poisson regression model with robust variances. RESULTS.: Of the 3231 participants included, 84.6% were young adults (18-29 years old), 62.7% were women, and 59.7% consumed a medicinal plant to prevent COVID-19 infection. The factors associated with the consumption of medicinal plants to prevent COVID-19 infection were residing in the Peruvian highlands, having had a family member diagnosed with COVID-19, having had a family member die from COVID-19, considering their family to be at increased risk of infection, having used medications or chlorine dioxide to prevent COVID-19, having medical information as the main source of information about COVID-19, thinking that medicinal plants are effective in preventing COVID-19 disease, or not being informed about their effectiveness. CONCLUSION.: Sixty percent of the participants reported having consumed a medicinal plant to prevent COVID-19. Authorities must apply communication strategies about the implications of consuming medicinal plants, prioritizing population groups with higher consumption patterns.
OBJETIVOS: Motivación para realizar el estudio. Ningún estudio recomienda de manera concluyente el uso de plantas medicinales para tratar los síntomas de la COVID-19, y su uso indiscriminado puede presentar riesgos para la salud. Principales hallazgos. El 60% de los participantes utilizó plantas medicinales para la prevención de la COVID-19. Especialmente aquellos de la sierra peruana y personas con familiares diagnosticados o fallecidos por COVID-19, que perciben mayores riesgos de contagio y utilizan medicamentos o dióxido de cloro como medidas preventivas. Implicancias. Las estrategias de comunicación esenciales para las prácticas preventivas validadas y la educación sobre los riesgos del consumo de plantas medicinales deben adaptarse a las características predominantes del consumidor. Determinar los factores asociados al consumo de plantas medicinales como prevención de la COVID-19 en la población peruana. MATERIALES Y MÉTODOS.: Se evaluó población mayor de 18 años, residentes en Perú y sin antecedentes de enfermedad por COVID-19. Los factores asociados al consumo de plantas medicinales se evaluaron mediante un modelo de regresión de Poisson con varianzas robustas. RESULTADOS.: De 3231 participantes incluidos, el 84,6% eran jóvenes (18-29 años), el 62,7% eran mujeres y el 59,7% consumía alguna planta medicinal para prevenir la COVID-19. Los factores asociados al consumo de plantas medicinales para prevenir el contagio de COVID-19 fueron residir en la sierra peruana, haber tenido un familiar diagnosticado con COVID-19, haber tenido un familiar fallecido por COVID-19, considerar que su familia se encuentra en mayor riesgo de infección, haber usado medicamentos o dióxido de cloro para prevenir la COVID-19, tener información médica como principal fuente de información sobre la COVID-19, pensar que las plantas medicinales son efectivas para prevenir la enfermedad COVID-19 o no estar informado sobre su eficacia. CONCLUSIÓN: . El 60% de los participantes reportó haber consumido alguna planta medicinal para prevenir la COVID-19. Es importante que las autoridades apliquen estrategias de comunicación sobre lo que implica el consumo de plantas medicinales, priorizando los grupos poblacionales que tienen mayores patrones de consumo.
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COVID-19 , Plantas Medicinales , Humanos , Perú/epidemiología , COVID-19/prevención & control , COVID-19/epidemiología , Estudios Transversales , Femenino , Masculino , Adulto , Adolescente , Adulto Joven , Persona de Mediana Edad , Anciano , Fitoterapia , Conocimientos, Actitudes y Práctica en SaludRESUMEN
OBJECTIVE: To evaluate the factors associated with poor medication adherence in patients with DM and HTN in Peru. STUDY DESIGN: A cross-sectional study. METHODS: We analyzed data from the Peruvian Demographic and Family Health Survey from 2014 to 2019. Adjusted prevalence ratios (aPR) and their respective 95% confidence intervals (CI) were estimated to determine the factors associated with poor medication adherence. RESULTS: We included 15,184 participants with a known diagnosis of DM and HTN. The frequency of poor medication adherence was 37.1%, with 36.7% among individuals with HTN and 29.2% among individuals with DM. Those belonging to age groups above 30 years (aPR: 0.77; 95% CI: 0.74-0.80, for the group ≥ 60 years) had a lower frequency of poor medication adherence. Meanwhile, being male (aPR: 1.03; 95% CI: 1.01-1.05), lacking health insurance (aPR: 1.08; 95% CI: 1.05-1.10), belonging to lower wealth quintiles (aPR: 1.12; 95% CI: 1.08-1.17, for the first quintile), and living in the mountain region (aPR: 1.09; 95% CI: 1.06-1.12) were associated with a higher frequency of poor medication adherence. These findings were consistent when stratifying by the type of disease. CONCLUSION: This study showed that poor medication adherence is common in patients with HTN and DM in Peru and is associated with sociodemographic factors, highlighting the importance of public health approaches to improve adherence.
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Diabetes Mellitus , Hipertensión , Cumplimiento de la Medicación , Humanos , Perú/epidemiología , Masculino , Cumplimiento de la Medicación/estadística & datos numéricos , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Femenino , Persona de Mediana Edad , Adulto , Estudios Transversales , Diabetes Mellitus/tratamiento farmacológico , Diabetes Mellitus/epidemiología , Adulto Joven , Anciano , Adolescente , Encuestas Epidemiológicas , Factores Socioeconómicos , Factores de RiesgoRESUMEN
OBJECTIVE: To synthesize the primary evidence on the efficacy and safety of visnadine on symptoms of sexual dysfunction (SD) in heterosexual women. METHODS: We conducted a systematic review of randomized clinical trials (RCTs) with a primary search without language restriction in PubMed/Medline, Scopus, Embase, Web of Science, Cochrane Library, and international clinical trial registries. Trials reporting the use of visnadine by any route in women with SD were eligible. We performed screening, data extraction, and risk of bias assessment in a double-blind approach. The primary outcomes were the Female Sexual Function Index (FSFI) and its domains. Secondary outcomes were safety, arousal, lubrication, pleasure, orgasm, negative sensations, duration, and overall satisfaction. RESULTS: Initially, 242 records were retrieved. We selected nine papers for full-text reading and finally included two RCTs: one with a parallel design and one with a crossover design with a total of 96 patients. One study compared visnadine aerosol with a placebo, while the other compared different frequencies of visnadine aerosol use. Visnadine use showed a statistically significant improvement (p < 0.05) in overall FSFI scores, regardless of the frequency of use. A meta-analysis was not possible due to the high clinical and methodological heterogeneity between available studies. CONCLUSION: RCTs regarding the use of visnadine for the Female SD are scarce and methodologically limited. This preliminary evidence shows visnadine as a potentially effective and safe option to alleviate some of the clinical symptoms of SD in heterosexual women. However, future better-designed randomized studies with larger sample numbers are required.
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Heterosexualidad , Ensayos Clínicos Controlados Aleatorios como Asunto , Disfunciones Sexuales Fisiológicas , Humanos , Femenino , Disfunciones Sexuales Fisiológicas/tratamiento farmacológico , Disfunciones Sexuales Psicológicas/tratamiento farmacológico , Resultado del TratamientoRESUMEN
Background: Invasive management of stable coronary artery disease is still a controversial topic. The purpose of this umbrella review was to synthesize systematic reviews (SRs) that evaluate the benefits and harms of percutaneous coronary intervention (PCI) versus optimal medical therapy (OMT) in patients with stable coronary artery disease. Methods: We systematically searched PubMed/MEDLINE, Embase, and CENTRAL from 2018 to August 7, 2022. We included SRs with meta-analyses of randomized controlled trials (RCTs) that evaluated the question of interest. We assessed the methodological quality of the SRs with the AMSTAR-2 tool. We summarized the results of the outcomes for each SR. We calculated the degree of overlap of the RCTs included in the SRs using the corrected covered area (CCA). Results: We found 10 SRs with meta-analyses. The SRs included 3 to 15 RCTs. The degree of overlap among the SRs was very high (CCA > 15%). No SR evaluated the certainty of the evidence using the GRADE system and 9 out of 10 had critically low methodological quality. The SRs reported heterogeneous results for the outcomes of all-cause mortality, myocardial infarction, revascularization, and angina. On the other hand, for the outcomes of cardiovascular mortality and stroke, all SRs agreed that there were no differences between PCI and OMT alone. Conclusions: We found 10 SRs on the use of PCI compared to OMT alone for patients with stable coronary artery disease. However, none had high methodological quality, none evaluated the certainty of the evidence using the GRADE approach, and the results were inconsistent for several outcomes. This variability in evidence may result in divergent clinical decisions for the management of stable coronary artery disease among healthcare professionals. It is necessary to perform a high-quality SR using the GRADE approach to clarify the balance of benefits and harms of PCI.
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BACKGROUND: Intimate partner violence (IPV) in Peru represents a significant public health challenge. IPV can influence women's reproductive and social behaviors, undermining fertility control, and exacerbating unintended pregnancies. Our objective was to assess the association between IPV and pregnancy intention among Peruvian women of reproductive age. METHODS: We conducted a secondary analysis of Peru's 2020 Demographic and Family Health Survey data. The independent variable in this study was IPV against women, which includes psychological IPV, sexual IPV, and physical IPV. If a respondent experienced any of these three forms of IPV, the IPV variable was labeled as "yes"; if none were present, it was labeled as "no". The dependent variable was pregnancy intention (no vs. yes). We utilized a generalized linear model (GLM) from the Poisson family with a log link function to assess the relationship between IPV occurrences (total and each IPV type) and pregnancy intention. We report crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (95%CI). RESULTS: We analyzed data from 8466 women aged 15 to 49. The prevalence of any IPV was 49.6% (psychological IPV: 45.8%; physical IPV: 22.2%; and sexual IPV: 4.3%). Exposure to physical IPV (aPR: 1.05; 95% CI: 1.03-1.07), psychological IPV (aPR: 1.04; 95% CI: 1.02-1.06), and sexual IPV (aPR: 1.09; 95% CI: 1.04-1.13), as well as a history of any IPV (aPR: 1.05; 95% CI: 1.02-1.07), were associated with a higher probability of not intending to become pregnant. This association persisted after adjusting for confounders like age, marital status, educational attainment, education level of the child's father, place of residence, wealth, ethnicity, and parity. CONCLUSION: One in two Peruvian women reported experiencing IPV. An association was observed between IPV exposure and a higher probability of not holding an intention to become pregnant.
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Violencia de Pareja , Parejas Sexuales , Embarazo , Niño , Humanos , Femenino , Perú , Parejas Sexuales/psicología , Encuestas Epidemiológicas , Prevalencia , Factores de RiesgoRESUMEN
We aimed to conduct a scoping review to assess the profile of retracted health sciences articles authored by individuals affiliated with academic institutions in Latin America and the Caribbean (LAC). We systematically searched seven databases (PubMed, Scopus, Web of Science, Embase, Medline/Ovid, Scielo, and LILACS). We included articles published in peer-reviewed journals between 2003 and 2022 that had at least one author with an institutional affiliation in LAC. Data were collected on the year of publication, study design, authors' countries of origin, number of authors, subject matter of the manuscript, scientific journals of publication, retraction characteristics, and reasons for retraction. We included 147 articles, the majority being observational studies (41.5%). The LAC countries with the highest number of retractions were Brazil (n = 69), Colombia (n = 16), and Mexico (n = 15). The areas of study with the highest number of retractions were infectology (n = 21) and basic sciences (n = 15). A retraction label was applied to 89.1% of the articles, 70.7% were retracted by journal editors, and 89.1% followed international retraction guidelines. The primary reasons for retraction included errors in procedures or data collection (n = 39), inconsistency in results or conclusions (n = 37), plagiarism (n = 21), and suspected scientific fraud (n = 19). In conclusion, most retractions of scientific publications in health sciences in LAC adhered to international guidelines and were linked to methodological issues in execution and scientific misconduct. Efforts should be directed toward ensuring the integrity of scientific research in the field of health.
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Objective: To assess the association between witnessing domestic violence against the mother in childhood and intimate partner violence (IPV) in adulthood. Study design: An analytical cross-sectional study was conducted using data from the 2019 Peruvian Demographic and Family Health Survey (ENDES). The independent variable was the condition of witnessing physical violence by the father against the mother during childhood. The dependent variable was IPV, defined by the presence of some subtype of violence (physical, psychological, and sexual) against the respondent in the last year by her husband or partner. To assess this association, generalized linear models of the Poisson Family with a logarithmic link function were performed to estimate crude and adjusted prevalence ratios (aPR) with their respective 95% confidence intervals (95% CI). Results: Data from 17,911 Peruvian women between 15 and 59 years of age were analyzed. Most women were between 30 and 49 years old (71.4%), were cohabiting (65.0%), and had secondary education (43.2%). The prevalence of IPV in the last year was 16.0%, and the history of witnessing domestic violence against the mother during childhood was 42.0%. In the regression models, those with the studied exposure showed a higher prevalence of experiencing an episode of IPV in the last year (any IPV [aPR: 1.69; 95% CI: 1.50-1.91]; physical IPV [aPR: 1.70; 95% CI: 1.43-2.02], psychological IPV [aPR: 1.64; 95% CI:1.42-1.88], and sexual IPV [aPR: 1.68; 95% CI: 1.22-2.32]). Conclusions: Women with a history of domestic violence towards their mothers were likelier to have had IPV in the last year than women who did not report violence towards their mothers during childhood. Approximately two in ten Peruvian women reported having had IPV in the past year, and nearly half reported witnessing domestic violence against their mother as a child.
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We summarize the clinical trials (CTs) main characteristics, including members of ethnic minorities from Latin America. We carried out a systematic search in six databases. We made a descriptive synthesis of CTs, summarizing the characteristics, interventions, main findings, results, and conclusions reported. 4411 studies were acquired in search strategy, leaving 24 CTs in the final selection. Of these, ten were randomized, four were non-randomized, and the remainder had other designs. Most of the studies were carried out in the population of infants and children (08), ten of the studies included only women, and two studies included men. Nine studies were conducted in Mexico, with the Mayan ethnic minority being mostly evaluated (05). In only 15 it was mentioned that their research was approved by a research ethics committee. Finally, half of the CTs reported funding from international agencies and third reported funding from government agencies. Our results show that that CTs in ethnic minorities are limited and reduced to a few native peoples of the continent.
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Ensayos Clínicos como Asunto , Minorías Étnicas y Raciales , Humanos , América Latina/etnología , Región del Caribe/etnología , Masculino , Femenino , Grupos Minoritarios , Etnicidad/estadística & datos numéricosRESUMEN
Exploring the landscape of intracranial aneurysms in South America unravels a complex interplay of epidemiological factors, clinical manifestations, and therapeutic challenges. The study methodically conducts a comprehensive literature review spanning the years 2003 to 2023, focusing on English-language articles obtained from diverse databases to elucidate the multifaceted nature of intracranial aneurysms in the region. Results and discussions categorize outcomes into positive domains, emphasizing successful treatments, favorable recoveries, and high survival rates, while also shedding light on negative aspects such as residual aneurysms and complications. The research illuminates significant gaps in pathological typing of intracranial aneurysms and exposes challenges in healthcare accessibility, notably the disparities in neurosurgical resources. Management challenges, including constrained infrastructure access, a neurosurgeon shortage, and gender disparities, are underscored. Transitioning to future prospects, the study advocates for strategic interventions, proposing expanded neurosurgical training, multidisciplinary approaches, improved funding, enhanced access to care, and fostering international collaborations. The study concludes by emphasizing the pivotal role of collaborative efforts, intensified training programs, and global partnerships in propelling intracranial aneurysm management forward in South America, ultimately contributing to enhanced patient outcomes across the region.
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Aneurisma Intracraneal , Humanos , Aneurisma Intracraneal/epidemiología , Aneurisma Intracraneal/terapia , Aneurisma Intracraneal/cirugía , América del Sur/epidemiología , Procedimientos Neuroquirúrgicos , Neurocirujanos , Accesibilidad a los Servicios de SaludRESUMEN
OBJECTIVE: To evaluate the factors associated with non-help-seeking in victims of physical or sexual intimate partner violence (IPV) in Peru. METHODS: This was an analytical cross-sectional study of 3-year data from the Peruvian Demographic and Health Survey. The sample comprised women aged 18 to 49 who had experienced physical or sexual IPV at some time in their lives. The dependent variable was non-help-seeking after suffering physical or sexual IPV. Adjusted prevalence ratios (aPR) with their 95% confidence interval (CI) were calculated to assess the factors associated with non-help-seeking. In addition, a sensitivity analysis was carried out in which only women who suffered physical or sexual IPV in the last year were considered. RESULTS: Data from 15,265 female victims of physical or sexual IPV were analyzed. It was found that 57.4% did not seek help after suffering physical or sexual IPV. The main reasons for non-help-seeking included thinking it was unnecessary (42.3%) and embarrassment (14.9%). Age between 30 and 49 years old (PRa:1.15; 95%CI [1.06, 1.25]) and residing in a rural area (PRa:1.07; 95%CI [1.00, 1.13]) were associated with a higher probability of non-help-seeking. On the other hand, having a secondary education level (PRa:0.91; 95% CI [0.86, 0.97]) or higher (PRa:0.90; 95%CI [0.82, 0.99]), having a partner who drinks alcohol (PRa:0.94; 95%CI [0.89, 0.99]), having experienced physical or sexual IPV during a pregnancy (PRa:0.87; 95%CI [0.80, 0.94]), and having experienced moderate (PRa:0.81; 95%CI [0.76, 0.86]), or severe physical or sexual IPV (PRa:0.74; 95%CI [0.67, 0.82]), were associated with a lower probability of non-help-seeking. These associations were consistent in the sensitivity analysis. CONCLUSION: Half of the women who experience physical or sexual IPV do not seek help. There are sociodemographic factors related to this non-seeking of help that are useful for identifying and prioritizing interventions to reduce IPV and improve the health status of women.
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Violencia de Pareja , Humanos , Femenino , Adulto , Perú , Persona de Mediana Edad , Estudios Transversales , Adulto Joven , Violencia de Pareja/estadística & datos numéricos , Adolescente , Aceptación de la Atención de Salud/estadística & datos numéricos , Encuestas Epidemiológicas , Prevalencia , Delitos Sexuales/estadística & datos numéricos , Delitos Sexuales/psicologíaRESUMEN
RESUMEN Objetivos . Determinar los factores asociados al consumo de plantas medicinales como prevención de la COVID-19 en la población peruana. Materiales y métodos. Se evaluó población mayor de 18 años, residentes en Perú y sin antecedentes de enfermedad por COVID-19. Los factores asociados al consumo de plantas medicinales se evaluaron mediante un modelo de regresión de Poisson con varianzas robustas. Resultados. De 3231 participantes incluidos, el 84,6% eran jóvenes (18-29 años), el 62,7% eran mujeres y el 59,7% consumía alguna planta medicinal para prevenir la COVID-19. Los factores asociados al consumo de plantas medicinales para prevenir el contagio de COVID-19 fueron residir en la sierra peruana, haber tenido un familiar diagnosticado con COVID-19, haber tenido un familiar fallecido por COVID-19, considerar que su familia se encuentra en mayor riesgo de infección, haber usado medicamentos o dióxido de cloro para prevenir la COVID-19, tener información médica como principal fuente de información sobre la COVID-19, pensar que las plantas medicinales son efectivas para prevenir la enfermedad COVID-19 o no estar informado sobre su eficacia. Conclusión . El 60% de los participantes reportó haber consumido alguna planta medicinal para prevenir la COVID-19. Es importante que las autoridades apliquen estrategias de comunicación sobre lo que implica el consumo de plantas medicinales, priorizando los grupos poblacionales que tienen mayores patrones de consumo.
ABSTRACT Objectives. Determine the factors associated with the consumption of medicinal plants as a preventive measure against COVID-19 in the Peruvian population. Materials and methods. A population over 18 years of age, living in Peru and without a history of COVID-19 disease, was evaluated. The factors associated with the consumption of medicinal plants were evaluated using a Poisson regression model with robust variances. Results. Of the 3231 participants included, 84.6% were young adults (18-29 years old), 62.7% were women, and 59.7% consumed a medicinal plant to prevent COVID-19 infection. The factors associated with the consumption of medicinal plants to prevent COVID-19 infection were residing in the Peruvian highlands, having had a family member diagnosed with COVID-19, having had a family member die from COVID-19, considering their family to be at increased risk of infection, having used medications or chlorine dioxide to prevent COVID-19, having medical information as the main source of information about COVID-19, thinking that medicinal plants are effective in preventing COVID-19 disease, or not being informed about their effectiveness. Conclusion. Sixty percent of the participants reported having consumed a medicinal plant to prevent COVID-19. Authorities must apply communication strategies about the implications of consuming medicinal plants, prioritizing population groups with higher consumption patterns.
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RESUMEN Objetivo. El trastorno del espectro autista (TEA) se caracteriza por alteraciones en el desarrollo, dificultades de interacción social y comunicación, y patrones restrictivos y repetitivos de conducta. A pesar de su alta prevalencia, pocos estudios se han realizado en ambientes de rehabilitación. El objetivo del estudio fue describir las características de los niños con TEA atendidos en el Servicio de Rehabilitación Pediátrica del Hospital Rebagliati (SRP-HNERM). Materiales y métodos. Estudio descriptivo transversal. Se revisaron las historias clínicas de niños menores de 14 años con diagnóstico previo de TEA atendidos en el SRP-HNERM durante el 2022. Resultados. Se evaluaron a 120 niños con TEA. La mediana de edad fue de cinco años. La mayoría recibía educación regular, pero solo para el 9,8% fue inclusiva. La media de edad de diagnóstico fue de 3,83 años. El 78,4% no tenía certificado de discapacidad y el 77,5% tenía evaluación psicológica incompleta. La mediana del tiempo transcurrido desde las últimas sesiones de terapia física, ocupacional y de lenguaje fue de 3, 8 y 3,5 meses respectivamente. Conclusión. La media de edad de diagnóstico de TEA fue mayor de tres años y más del 75% de los pacientes no contaban con un certificado de discapacidad ni con una evaluación psicológica completa. La mediana del tiempo desde las últimas sesiones de terapias de rehabilitación fue de tres meses o más. Estos hallazgos resaltan la necesidad de potenciar el diagnóstico temprano, la educación inclusiva y la evaluación y posterior certificación de la discapacidad, así como de establecer intervenciones más oportunas.
ABSTRACT Objective. Autism spectrum disorder (ASD) is characterized by developmental disorders, difficulties in social interaction and communication, and restrictive and repetitive patterns of behavior. Despite its high prevalence, few studies have been conducted in rehabilitation settings. This study aimed to describe the characteristics of children with ASD from the Pediatric Rehabilitation Service of the Rebagliati Hospital (SRP-HNERM). Materials and methods. Cross-sectional descriptive study. We reviewed the medical records of children under 14 years of age previously diagnosed with ASD from the SRP-HNERM during 2022. Results. A total of 120 children with ASD were evaluated. The median age was 5 years. Most received regular education, but it was inclusive only for 9.8%. The mean age at diagnosis was 3.83 years. We found that 78.4% had no disability certificate and 77.5% of the participants had incomplete psychological evaluation. The median time since the last physical, occupational and speech therapy sessions was 3, 8 and 3.5 months respectively. Conclusion. The mean age at diagnosis of ASD was older than three years, and more than 75% of the patients had neither a disability certificate nor a complete psychological evaluation. The median time since the last rehabilitation therapy sessions was three months or more. Our findings highlight the need to improve early diagnosis, inclusive education and evaluation and subsequent certification of disability, as well as to establish timely interventions.
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Type 2 diabetes (T2D) is a chronic systemic disease with a complex etiology, characterized by insulin resistance and mitochondrial dysfunction in various cell tissues. To explore this relationship, we conducted a secondary analysis of complete mtDNA sequences from 1261 T2D patients and 1105 control individuals. Our findings revealed significant associations between certain single-nucleotide polymorphisms (SNPs) and T2D. Notably, the variants m.1438A>G (rs2001030) (controls: 32 [27.6%], T2D: 84 [72.4%]; OR: 2.46; 95%CI: 1.64-3.78; p < 0.001), m.14766C>T (rs193302980) (controls: 498 [36.9%], T2D: 853 [63.1%]; OR: 2.57, 95%CI: 2.18-3.04, p < 0.001), and m.16519T>C (rs3937033) (controls: 363 [43.4%], T2D: 474 [56.6%]; OR: 1.24, 95%CI: 1.05-1.47, p = 0.012) were significantly associated with the likelihood of developing diabetes. The variant m.16189T>C (rs28693675), which has been previously documented in several studies across diverse populations, showed no association with T2D in our analysis (controls: 148 [13.39] T2D: 171 [13.56%]; OR: 1.03; 95%CI: 0.815-1.31; p = 0.83). These results provide evidence suggesting a link between specific mtDNA polymorphisms and T2D, possibly related to association rules, topological patterns, and three-dimensional conformations associated with regions where changes occur, rather than specific point mutations in the sequence.
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Introduction: Peru is the fifth country in Latin America with the highest maternal mortality. In Peru, immediate puerperal control (IPC) was established in 2013 as a measure to improve postnatal control, with a view in reducing maternal mortality. This study aimed to evaluate the frequency and sociodemographic factors associated with compliance with IPC in Peru, 2019. Methods: We conducted an analytical cross-sectional study based on the Demographic and Family Health Survey (ENDES, for its acronym in Spanish) of Peru, 2019. The dependent variable was compliance with IPC (control in the first 2 h) in women aged 15-49 years who had delivered within the last five years preceding the survey. To evaluate the associated factors, Poisson family generalized linear models were used to calculate crude (cPR) and adjusted (aPR) prevalence ratios, with their respective 95% confidence intervals (95%CI). Results: Data from 11,854 women were analyzed. The frequency of IPC was 59.6% (95%CI: 58.3-60.9). We found a lower proportion of IPC in urban areas (58.8%) and in the highlands (57%) and jungle (57.2%) of Peru. Residing in rural areas (aPR:1.13; 95%CI:1.08-1.19), having undergone appropriate antenatal care (ANC) (aPR:1.05; 95%CI:1.01-1.10) and having delivered a low-birth-weight newborn (aPR:1.20; 95%CI:1.12-1.29) were associated with a higher frequency of IPC, while living in the highlands (aPR:0.86; 95%CI:0.80-0.92) or jungle (aPR:0.86; 95%CI:0.80-0.92) was associated with a lower frequency of IPC. Conclusions: Approximately four out of ten women did not have IPC. There was a lower proportion of IPC in urban areas and in the highland and jungle regions.
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Objective: We aimed to evaluate the determinants of non-institutional delivery among women of childbearing age in Peru. Methods: We conducted a secondary analysis of data from the Peru 2019 Demographic and Family Health Survey (ENDES). This multi-stage survey sampling is representative at the urban-rural, regional, and national levels. The outcome variable was place of delivery, collected by self-reporting. Binary logistic regression models were used to assess the factors associated with non-institutionalized delivery. Thus, we estimated crude and adjusted odd ratios (aOR). For the multivariable model, the manual forward selection method and the Wald test were used to obtain a final parsimonious model. Results: The final sample included 14,061 women of reproductive age between the ages of 15 and 49. The prevalence of non-institutional delivery was 7.8 %. Multivariate regression analysis found that having a secondary education (aOR:0.48; 95 % confidence interval [CI]:0.39-0.58) or higher (aOR:0.57; 95 %CI:0.42-0.78); belonging to the second (aOR:0.26; 95 %CI:0.20-0.33), third (aOR:0.28; 95 %CI:0.21-0.38), fourth (aOR:0.21; 95 %CI:0.13-0.33), or fifth wealth quintile (aOR:0.15; 95 %CI:0.09-0.27); and suffering intimate partner violence (aOR:0.76; 95 %CI:0.64-0.91) were associated with lower odds of non-institutional delivery, while not having some type of health insurance (aOR:3.12; 95 %CI:2.47-3.95), living in a rural area (aOR:1.93; 95 %CI:1.54-2.42), and having had three or more deliveries (aOR:1.36; 95 %CI:1.07-1.72), were associated with higher odds of non-institutional delivery. Conclusions: We found that not having health insurance, residing in a rural area, and having had three or more deliveries were factors associated with non-institutional delivery in women of childbearing age. We propose that should focus public health strategies towards providing education to women about maternal health, and likewise, facilitating access to specialized health centers for rural populations.