Factors Associated with the Development of Chronic Kidney Disease in Patients with Arterial Hypertension.

Introduction: Chronic kidney disease affects a large part of the population with hypertension, diabetes mellitus as well as those over 50 years of age. Research reported that male sex and other comorbidities such as obesity and anemia are more frequent in Chronic kidney disease, as well as uncontrolled diabetes mellitus or hypertension. Objective: To determine the risk factors associated with the development of chronic kidney disease in adults with arterial hypertension. Material and Methods: Retrospective cohort study of 455 patients with hypertension treated in a primary health care hospital. Medical records and laboratory information were reviewed for the diagnosis of chronic kidney disease and its staging. Patients aged 40 years and older, of both sexes and evaluated between the years 2015 -2017 were included. Logistic regression analysis allowed the identification of risk factors associated with the development of chronic kidney disease. Results: 63.7% were female and 36.3% male. The average age for 2015 was 69.79 ± 9.03, more than half of participants had diabetes mellitus and controlled hypertension and the predominant nephroprotection was with Losartan (53%) that year. Male sex (OR 1.68, CI 1.03-2,76), age: 60 years or older (OR 6.38, CI 2.65-15,37) and anemia (OR 1.71, CI 1.03-2,85), were risk factors for the development of chronic kidney disease (p < 0.05), whereas nephroprotection (OR 0.39, CI 0.18-0,88) and controlled diabetes mellitus (OR: 0.18, CI 0.07-0,47) were shown to be protective factors (p < 0.05). The prevalence of chronic kidney disease between 2015 and 2017 was 19% and 45%, respectively, with predominance of category G2. The comparison group is the same cohort analyzed in each year under study. Conclusion: Male sex, age over 60 years, and anemia are risk factors for chronic kidney disease. Nephroprotection, controlled diabetes mellitus, and patient follow-up are factors that prevent its development.

DNA Damage in Bat Blood Leukocytes Using a Chromatin Dispersion Test (CDT): Biomarker of Environmental Genotoxicity.

Environmental pollutants produce adverse effects on organisms and ecosystems. Biomonitoring and biomarkers offer a reasonable approach to make these assessments. Induced genetic changes can be using as a biomarker in organisms that react to a given compound in the ecosystem. Monitoring environmental genotoxicity necessitates the choice of model animals known as "sentinels or biological monitors" and the suitability of validated tests for DNA damage evaluation. We aimed to estimate the DNA damage produced by thermal stress in the leukocytes of the Mexican free-tailed bat (Tadarida brasiliensis). The DNA damage in bat leukocytes exposed to different temperatures (35 °C, 45 °C, and 55 °C) was evaluated by the adapted chromatin dispersion test (CDT) and the results were confirmed by the alkaline comet test. The CDT permitted a clear representation of leukocytes with fragmented DNA and of nonfragmented DNA. In addition, we detected nuclear anomalies in relation to cell death cellular swelling, nuclear fragmentation, and chromatin lysis. The alkaline comet assay revealed that the halos of diffuse chromatin include fragmented DNA. The assay of the method employing the CDT is well established, precise, and cost-effective for the routine quantitative analysis of DNA damage on the effect of the leukocytes of bats exposed to thermal stress. This could also apply as a sensitive screening tool for the evaluation of genotoxicity in environmental protection programs.

Differences in family functioning before and during the COVID-19 pandemic: an observational study in Peruvian families.

The COVID-19 pandemic has had a major impact on family relationships, as several families have lost family members due to COVID-19 pandemic and become physically and emotionally estranged due to lockdown measures and critically economic periods. Our study contrasted two hypotheses: (1) family functioning changed notably before and after the COVID-19 pandemic initiation in terms of cohesion, flexibility, communication and satisfaction; (2) balanced families have a greater capacity to strictly comply with quarantine (i.e., social confinement), compared to unbalanced families. We performed an observational study comparing family functioning between two independent groups, evaluated before and during the first wave of the COVID-19 pandemic in Peru. A total of 7,980 participants were included in the study. For the first hypothesis, we found that, during the pandemic, families became more balanced in terms of cohesion (adjusted before-during mean difference or ß1 = 1.4; 95% CI [1.0-1.7]) and flexibility (ß2 = 2.0; 95% CI [1.6-2.4]), and families were less disengaged (ß3 = -1.9; 95% CI [-2.3 to -1.5]) and chaotic (ß4 = -2.9; 95% CI [-3.3 to -2.4]). Regarding the second hypothesis, we confirmed that families with balanced cohesion (adjusted prevalence ratio or aPR = 1.16; 95% CI [1.12-1.19) and flexibility (aPR = 1.23; 95% CI [1.18-1.27]) allowed greater compliance with quarantine restrictions; while disengaged (aPR = 0.91; 95% CI [0.88-0.93]) and chaotic families (aPR = 0.89; 95% CI [0.87-0.92]) were more likely to partially comply or not comply with the quarantine. Finally, family communication (aPR = 1.17; 95% CI [1.11-1.24]) and satisfaction (aPR = 1.18; 95% CI [1.11-1.25]) also played a role in favouring quarantine compliance. This new evidence enlightens the family systems theory while informing future interventions for improving compliance with quarantine measures in the context of social confinement.

Post-infection sequelae by COVID 19 in patients at Hospital I Florencia de Mora. Trujillo - Peru / Secuelas post infección por COVID 19 en pacientes del Hospital I Florencia de Mora. Trujillo - Perú

Objetivos: Identificar secuelas post COVID-19 en pacientes con alta médica para dicha patología. Métodos: se realizó un estudio descriptivo prospectivo entre el segundo y cuarto trimestre 2021 con una población de 330 pacientes diagnosticados con COVID-19. Al inicio del estudio se estableció la línea de base y luego se realizó seguimiento y consulta de control para identificar secuelas post COVID-19 y realizar espirometría de control. Resultados: La frecuencia de COVID 19 fue de 29.78% (330 casos/1108 atendidos). El 43.94% de casos positivos se presentó en el grupo de 40-59 años, el 28.8% (95/330) refirieron como comorbilidad: la enfermedad cardiovascular, diabetes mellitus II y asma bronquial. Predominaron las secuelas post COVID-19: respiratorias (61%), osteomusculares (43%) y neurológicas (20%), con disnea, dorsalgia y cefalea respectivamente. La duración de las secuelas fue de 21 días a siete meses, la espirometría mostró un patrón restrictivo leve en pacientes de 41 a 50 años, todas de sexo femenino. Conclusiones: Es importante identificar secuelas post COVID-19 para el tratamiento que permita recuperar la salud integral de las personas.

Objectives: To identify post COVID-19 sequelae in patients with medical discharge for this pathology. Methods: A prospective descriptive study was conducted between the second and fourth quarter of 2021 with a population of 330 patients diagnosed with COVID-19. Baseline was established at the beginning of the study, followed by follow-up and control consultation to identify post-COVID-19 sequelae and to perform control spirometry. Results: The frequency of COVID-19 was 29.78% (330 cases/1108 attended). The 43.94% of positive cases were in the 40-59 years age group, 28.8% (95/330) referred as comorbidity: cardiovascular disease, diabetes mellitus II and bronchial asthma. Post COVID-19 sequelae predominated: respiratory (61%), musculoskeletal (43%) and neurological (20%), with dyspnea, dorsalgia and headache, respectively. The duration of sequelae ranged from 21 days to seven months, spirometry showed a mild restrictive pattern in patients aged 41 to 50 years, all female. Conclusions: It is important to identify post-COVID-19 sequelae for treatment to recover the integral health of individuals.

Nivel de resiliencia del personal de salud frente a la pandemia por Covid-19 / Resilience level in health personnel facing the Covid-19 pandemic

Introducción: La resiliencia es un factor determinante para ayudar a afrontar alguna situación de estrés, por ello el objetivo de nuestro estudio, fue medir el nivel de resiliencia en el personal de salud en dos hospitales de la ciudad de Trujillo frente a la pandemia por Covid-19. El estudio: Se realizó un estudio descriptivo transversal con 106 trabajadores de salud, a quienes mediante una entrevista se les administró un cuestionario compuesto de 25 ítems. Hallazgos: Se encontró que la mayor parte de participantes fueron del sexo femenino (67,9% vs 32,1%) y 40,6%, personal médico. En ambos hospitales se halló un nivel alto de resiliencia, 95% en el Hospital La Noria y 98% en EsSalud-La Esperanza. Conclusiones: El personal de salud presentó nivel alto de resiliencia frente a la pandemia del Covid-19.

Introduction: Resilience is a determining factor in helping to face some stressful situation, therefore the objective of our study, was to measure the level of resilience in health personnel in two hospitals in the city of Trujillo in the face of the Covid-19 pandemic. The study: A cross-sectional descriptive study was conducted with 106 health workers, who were administered a questionnaire composed of 25 items by means of an interview. Findings: It was found that the majority of participants were female (67.9% vs 32.1%) and 40.6%, medical personnel. A high level of resilience was found in both hospitals, 95% in Hospital La Noria and 98% in EsSalud-La Esperanza. Conclusions: Health personnel presented high level of resilience in the face of the Covid-19 pandemic.

Características clínico epidemiológicas de pacientes con diagnóstico de SARS-CoV-2. Hospital I Florencia de Mora EsSalud ­ La Libertad, 2020 / Clinical epidemiological characteristics of patients diagnosed with SARS-CoV-2. Hospital I Florencia de Mora EsSalud ­ La Libertad, 2020

Introducción: La pandemia por SARS-CoV-2 afectó a gran parte de la población liberteña, entre ellas, la población de Florencia de Mora, cuyo hospital tuvo un importante rol en la atención de pacientes con diagnóstico de COVID-19. Ojetivos: Determinar las características clínico-epidemiológicas de los pacientes con diagnóstico por SARS-CoV-2 atendidos en dicho centro asistencial. Métodos: Estudio descriptivo observacional, retrospectivo, con una población de 2622 pacientes atendidos en el triaje de COVID-19, considerando la prueba molecular y la prueba serológica rápida para la detección de SARS-CoV-2. Resultados: Se detectó SARS-CoV-2 en 74.90% (1155) de los pacientes. Los meses con mayor número de casos fueron junio y julio con el 29.4% (340) y 37.4% (432), respectivamente. El grupo etario predominante fue de 27-59 años con el 77.9% (900), así como el sexo masculino con un 57.5% (664). En cuanto al perfil clínico, la comorbilidad más frecuente fue la hipertensión arterial con 6.9% (80), la obesidad y sobrepeso con 3.7% (43); mientras que la sintomatología más frecuente fue la tos con 62.9% (726), y la odinofagia con 55.7% (643). Conclusión: 75 de cada 100 pacientes tamizados tuvieron SARS-CoV-2; predominando el sexo masculino, el grupo etario de 27-59 años, hipertensión arterial, obesidad y sobrepeso como comorbilidad, tos y la odinofagia como síntomas más frecuentes.

Introduction: The SARS-CoV-2 pandemic affected a large part of the population of La Libertad, among them, the population of Florencia de Mora whose hospital played an important role in the care of patients diagnosed with COVID-19. Objectives: To determine the epidemiological clinical characteristics of patients diagnosed with SARS-CoV-2 treated at treated at the center. Methods: Retrospective observational descriptive study, with a population of 2622 patients treated in the COVID Triage, considering the molecular test and the rapid serological test for the detection of SARS-CoV-2. Results: SARS-CoV-2 was detected in 74.90% (1155), the months with the highest number of cases were June and July with 29.4% (340) and 37.4% (432) respectively, the predominant age group was 27- 59 years with 77.9% (900) and males with 57.5% (664). Regarding the clinical profile, the most frequent comorbidity was arterial hypertension with 6.9% (80), obesity and overweight with 3.7% (43) and the most frequent symptoms were: cough 62.9% (726) and odynophagia 55.7% (643). Conclusions: 75 out of 100 screened patients had SARS-CoV-2; predominantly males, the age group of 27-59 years, hypertension, obesity and overweight as comorbidity, cough and odynophagia as the most frequent symptoms.

Diabetes mellitus tipo 3c secundaria a pancreatitis crónica: reporte de un caso / Type 3c diabetes mellitus secondary to chronic pancreatitis: a case report

RESUMEN La diabetes mellitus secundaria a enfermedades pancreáticas está clasificada como diabetes pancreatogénica o tipo 3c (DM3c), y es clínica y metabólicamente distinta de las otras formas de diabetes. Se presenta el caso de una paciente de 35 años de edad con historia de dolor abdominal superior episódico crónico, que consume alcohol desde los 17 años y ha sido diagnosticada de diabetes mellitus tipo 2. Consulta por una infección urinaria complicada y por dolor agudo en el abdomen superior. Durante la hospitalización presentó episodios de hiperglicemia seguidos de hipoglicemias, con insulinoterapia administrada bajo supervisión. Este caso nos motiva para estudiar a los pacientes diabéticos con historia de dolor abdominal mal referido o signos de malabsorción y mejorar la intervención sanitaria para prevenir o tratar la desnutrición, controlar la esteatorrea y minimizar la hiperglucemia inducida por las comidas o estilos de vida.

ABSTRACT Diabetes mellitus secondary to pancreatic diseases is classified as pancreatogenic diabetes or type 3c diabetes mellitus (T3cDM), which is clinically and metabolically different from the other types of diabetes. We present the case of a 35-year-old female patient with a history of chronic episodic upper abdominal pain, alcohol consumption since she was 17, and type 2 diabetes mellitus. She sought medical attention because of a complicated urinary tract infection in addition to acute upper abdominal pain. During hospitalization, she presented episodes of hyperglycemia followed by hypoglycemia with insulin therapy administered under supervision. This case encourages us to delve into the study of diabetic patients with a history of poorly referred abdominal pain or malabsorption signs, thus improving health intervention to prevent or treat malnutrition, control steatorrhea, and reduce hyperglycemia induced by meals or lifestyles.

Hipoalbuminemia Como Predictor De Mortalidad De Sepsis Por COVID-19. Hospital II Chocope, 2020. / Hypoalbuminemia as a predicator of mortality of sepsis from COVID-19. Hospital II Chocope, 2020.

Se realizó una investigación de tipo correlacional evaluando a 145 pacientes con sepsis por covid-19. Objetivos: Determinar si la hipoalbuminemia es predictor de mortalidad e identificar el valor sérico de albumina más frecuentemente relacionado con la letalidad. Métodos: Se incluyeron a pacientes mayores o igual de 18 años atendidos en el Hospital II Chocope durante mayo a agosto del 2020. Se excluyeron a pacientes con patologías oncológicas, e historias clínicas incompletas. La técnica empleada es la de análisis documental, mediante la revisión de historias clínicas. Resultados: Hubo asociación estadísticamente significativa entre la hipoalbuminemia y mortalidad (p = 0.00), los pacientes con hipoalbuminemia tuvieron 3 veces más riesgo de fallecer. (OR=3.97 IC al 95%). Así mismo, la sensibilidad y especificidad más alta de la prueba fue cuando el punto de corte de la hipoalbuminemia estuvo en 1.38 g/dl. Finalmente, la hipertensión arterial es la enfermedad asociada más frecuente. Conclusiones: la hipoalbuminemia es predictor de mortalidad y a menor valor de albumina mayor mortalidad.

A correlational type investigation was carried out evaluating 145 patients with covid-19 sepsis. Objectives: To determine whether hypoalbuminemia is a predictor of mortality and to identify the serum albumin value most frequently related to lethality. Method: Patients older than or equal to 18 years seen at Hospital II Chocope during May to August 2020 were included. Patients with oncological pathologies and incomplete medical records were excluded. The documentary analysis technique was used, by reviewing medical records. Results: There was a statistically significant association between hypoalbuminemia and mortality (p = 0.00), patients with hypoalbuminemia had 3 times the risk of dying. (OR = 3.97 95% CI). Likewise, the highest sensitivity and specificity of the test was when the cut-off point for hypoalbuminemia was 1.38 g / dl. Finally, the most frequent comorbidity was arterial hypertension. Conclusions: hypoalbuminemia is a predictor of mortality and the lower the albumin value, the higher the mortality.

Perfil clínico-epidemiológico del síndrome metabólico en adultos atendidos en el hospital I Florencia de Mora EsSALUD / Clinical and epidemiological profile of the metabolic syndrome among adults treated at the Hospital I Florencia de Mora EsSalud

RESUMEN Objetivo Determinar el perfil clínico-epidemiológico del síndrome metabólico en adultos atendidos en el Hospital I Florencia de Mora EsSALUD. Materiales y métodos Estudio de tipo descriptivo, observacional y retrospectivo en una población de 4752 pacientes tamizados en el programa Reforma de Vida. Se aplicaron los criterios diagnósticos del síndrome metabólico de la Federación Internacional de Diabetes. Resultados La prevalencia del síndrome metabólico es de 38,97 %. En el perfil clínico, las variables más frecuentes fueron la obesidad central (97,50 %), un valor bajo de colesterol HDL (86,40 %) y la hipertrigliceridemia (80,10 %). Todas ellas mostraron significación estadística. En el perfil epidemiológico, las variables sexo femenino (68,10 %) y la edad "adulto maduro" (48,30 %) fueron las más frecuentes. Conclusiones Más de la tercera parte del total de la población estudiada presenta síndrome metabólico. En este grupo predominan la obesidad, el colesterol HDL bajo, la hipertrigliceridemia, la edad del adulto maduro y el sexo femenino.

ABSTRACT Objective To determine the clinical and epidemiological profile of the metabolic syndrome among adults treated at the Hospital I Florencia de Mora EsSalud. Materials and methods A retrospective, observational and descriptive study conducted in a population of 4,752 patients screened for the Reforma de Vida program. The International Diabetes Federation's diagnostic criteria for metabolic syndrome were used. Results The prevalence of metabolic syndrome is 38.97 %. The most frequent variables of the clinical profile were central obesity (97.50 %), low levels of HDL cholesterol (86.4 %) and hypertriglyceridemia (80.10 %). All these variables showed statistical significance. The most frequent variables of the epidemiological profile were female sex (68.10 %) and middle- age adult (48.30 %). Conclusions More than one third of the study population has metabolic syndrome. Obesity, low levels of HDL cholesterol, hypertriglyceridemia, middle-age adult and female sex prevailed in this group.

Influence of Heart Rate, Age, and Gender on Heart Rate Variability in Adolescents and Young Adults.

Key autonomic functions are in continuous development during adolescence which can be assessed using the heart rate variability (HRV). However, the influence of different demographic and physiological factors on HRV indices has not been fully explored in adolescents. In this study we aimed to assess the effect of age, gender, and heart rate on HRV indices in two age groups of healthy adolescents (age ranges, 13-16 and 17-20 years) and two groups of healthy young adults (21-24 and 25-30 years). We addressed the issue using 5-min ECG recordings performed in the sitting position in 255 male and female participants. Time, frequency, and informational domains of HRV were calculated. Changes in HRV indices were assessed using a multiple linear regression model to adjust for the effects of heart rate, age, and gender. We found that heart rate produced more significant effects on HRV indices than age or gender. There was a progressive reduction in HRV with increasing age. Sympathetic influence increased with age and parasympathetic influence progressively decreased with age. The influence of gender was manifest only in younger adolescents and young adults. In conclusion, age, gender, and particularly heart rate have a substantial influence on HRV indices, which ought to be considered to avoid biases in the study of the autonomic nervous system development. The lack of the gender-related effects on HRV indices in late adolescence could be related to non-completely achieved maturity of the autonomic mechanisms, which deserves further exploration.

Photolysis of 2,4,6-trinitrotoluene in seawater and estuary water: Impact of pH, temperature, salinity, and dissolved organic matter.

The influence of salinity, pH, temperature, and dissolved organic matter on the photolysis rate of 2,4,6-trinitrotoluene (TNT) in marine, estuary, and laboratory-prepared waters was studied using a Suntest CPS+® solar simulator equipped with optical filters. TNT degradation rates were determined using HPLC analysis, and products were identified using LC/MS. Minimal or no TNT photolysis occurred under a 395-nm long pass filter, but under a 295-nm filter, first-order TNT degradation rate constants and apparent quantum yields increased with increasing salinity in both natural and artificial seawater. TNT rate constants increased slightly with increasing temperature (10 to 32°C) but did not change significantly with pH (6.4 to 8.1). The addition of dissolved organic matter (up to 5mg/L) to ultrapure water, artificial seawater, and natural seawater increased the TNT photolysis rate constant. Products formed by TNT photolysis in natural seawater were determined to be 2,4,6-trinitrobenzaldehyde, 1,3,5-trinitrobenzene, 2,4,6-trinitrobenzoic acid, and 2-amino-4,6-dinitrobenzoic acid.