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.

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.

Criteria in the Diagnosis of Metabolic Syndrome in Children: A Scoping Review.

Currently, there is no consensus on the criteria for identifying metabolic syndrome in children, as observed in the diversity of research developed. For this reason, a scoping review was developed in this work, in order to compare the criteria for the diagnosis of metabolic syndrome (MetS) applied in children, described in observational, descriptive cross-sectional studies. The databases PubMed, Scopus, Web of Science and the search engine Google Scholar were used. The search terms "metabolic syndrome", "cardiometabolic syndrome", "child", "children" and "childhood" were considered, as well as the names of organizations or authors proposing identification criteria for MetS to establish search relationships using the Boolean connectors "AND" and "OR". Likewise, two reviewers carried out the evaluation and selection of articles, of which 26 articles were included in which children aged 6 to 12 participated. It was found that the most commonly used criteria for identifying MetS since 2015 are those of Cook et al, IDF, NCEP ATPIII, and De Ferranti et al, in that order. Specific criteria, such as those proposed by Cook et al, are being chosen to enhance the accuracy of identifying MetS in children. The most common risk factors in children with MetS are abdominal circumference and BMI, followed by triglycerides, HDL, blood pressure, and blood glucose. The prevalence of MetS in children varies according to the criteria used, being higher with De Ferranti et al.

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.

Modelo de predicción para Síndrome metabólico en adultos de Trujillo, Perú / Prediction model for metabolic syndrome in adults from Trujillo, Peru

RESUMEN Introducción: El síndrome metabólico es una confluencia de alteración metabólica que involucra la glicemia y el perfil lipídico, la presión arterial, y en especial la obesidad que aumentan el riesgo cardiovascular. Objetivo: Estimar un modelo de predicción de síndrome metabólico en adultos del Distrito de Trujillo (Perú), a partir de indicadores aterogénicos, antropométricos y estilos de vida. Material y Métodos: Participaron 260 adultos de 30 a 65 años de la Ciudad de Trujillo. El síndrome metabólico se identificó mediante criterios del ALAD y ATP III armonizado, y se aplicó un cuestionario de preguntas para estilos de vida. Para el análisis estadístico se utilizó la regresión logística. Resultados: Consumen gaseosa y snack 70,8 % y 38,5 %; no consumen frutas y verduras en 56,2 % y 58,1 %; y no realiza actividad física 47,7 %. Presentó síndrome metabólico según ALAD y ATP III 46,2 % y 48,1 %, respectivamente. Se asociaron según ALAD; el Índice de Masa Corporal (OR: 11,014; IC 95 %: 4,337-27,971); Índice Castelli (OR: 2,344; IC95 %: 1,074-5,113) y TG/HDL (OR: 3,584; IC 95 %: 1,774-7,242). Se asociaron según ATP III; el sexo (OR: 2,385; IC 95 %: 1,2-4,739); edad (OR: 1,939; IC 95%: 1,032 - 3,644); Índice de Masa Corporal (OR: 5,880; IC 95 %: 2,547-13,576); índice de Castelli (OR: 2,935; IC 95 %: 1,295-6,653) y TG/HDL (OR: 6,937; IC 95 % 3,232-14,889). No hubo asociación entre estilos de vida y síndrome metabólico. Conclusiones: El modelo de predicción para síndrome metabólico por ALAD involucra al Índice de Masa Corporal, Castelli e Índice TG/HDL; se adiciona género y edad en el modelo para síndrome metabólico por ATP III armonizado.

ABSTRACT Introduction: The metabolic syndrome is a confluence of metabolic alteration that involves blood glucose and lipid profile, blood pressure, and especially obesity that increase cardiovascular risk. Objective: To estimate a prediction model for metabolic syndrome (MS) in adults from the District of Trujillo (Peru) on the basis of atherogenic, anthropometric and lifestyle indicators. Material and Methods: A total of 260 adults between 30 and 65 years old from the City of Trujillo participated in the study. MS was identified using the ALAD and harmonized ATP III criteria, and a questionnaire containing questions on lifestyles was applied. Logistic regression was used for statistical analysis. Results: The results of the study show that 70.8% and 38.5% consume soda and snack; 56.2 % and 58.1 % do not consume fruits and vegetables; and 47.7 % of them do not do physical activity. According to ALAD and ATP III, 46.2 % and 48.1 % presented MS, respectively. The BMI (OR: 11.014; 95 % CI: 4.337-27.971); Castelli Index (OR: 2.344; 95 % CI: 1.074-5.113) and TG / HDL (OR: 3.584; 95 % CI: 1.774-7.242) were associated with MS according to ALAD criteria. Sex (OR: 2.385; 95 % CI: 1.2-4.739); Age (OR: 1,939; 95 % CI: 1,032 - 3,644); BMI (OR: 5.880; 95 % CI: 2.547-13.576); Castelli index (OR: 2,935; 95 % CI: 1,295-6,653) and TG/HDL (OR: 6,937; 95 % CI 3,232-14,889) were associated with MS according to ATP III criteria. There was no association between lifestyle and MS. Conclusions: It is concluded that the prediction model for MS according to ALAD criteria involves BMI, Castelli index and TG/HDL index; gender and age are added in the model for MS according to harmonized ATP III criteria.

Indicadores de aterogenicidad en la predicción del síndrome metabólico en adultos, Trujillo-Perú

RESUMEN Objetivo: Evaluar los indicadores de aterogenicidad en la predicción del síndrome metabólico. Métodos: Se realizó un estudio descriptivo, transversal en adultos de la ciudad de Trujillo en 321 personas de 25 a 65 años que acudieron a cuatro centros de salud, de julio a diciembre de 2019. El síndrome metabólico se determinó mediante criterios de la Asociación Latinoamericana de Diabetes (ALAD) 2018 y del Adult Treatment Panel III (ATP III). Resultados: La presencia de síndrome metabólico según los criterios del ALAD y ATPIII fue de 46,1% y 48,6% respectivamente. Los índices aterogénicos con valores de riesgo más prevalentes correspondieron al Colesterol No HDL 72%; Índice de Castelli 68,2% y el índice TG/HDL en 58,3% de los participantes. Tanto para el criterio ALAD como ATPIII, el índice aterogénico que mostró la mejor predicción fue el TG/HDL seguido del índice de Castelli en el caso del ATP III. Conclusión: El índice de TG/HDL es el indicador con mejor predicción del síndrome metabólico.

ABSTRACT Objective: To evaluate atherogenicity indicators in the prediction of metabolic syndrome. Methods: A descriptive, cross-sectional study was conducted in adults from the city of Trujillo in 321 people aged 25 to 65 years who accessed care at four health centers, between July-December 2019. Metabolic syndrome was determined by using criteria of the Latin American Diabetes Association (LADA) 2018 and the Adult Treatment Panel III (ATP III). Results: The presence of metabolic syndrome according to LADA and ATP III criteria was 46.1% and 48.6%, respectively. The atherogenic indexes with the most prevalent risk values corresponded to non HDL cholesterol 72%; Castelli index 68.2% and TG/HDL index in 58.3% of the participants. For both LADA and ATP III criteria, the atherogenic index that showed the best prediction was TG/HDL followed by the Castelli index in the case of ATP III. Conclusion: The TG/HDL index is the indicator with the best prediction of metabolic syndrome.

Factores asociados a las actitudes y prácticas preventivas frente a la pandemia del COVID-19

RESUMEN Objetivo: La presente investigación tuvo como objetivo analizar si existe relación entre los factores biológicos, sociales y culturales con las actitudes y prácticas preventivas frente a la pandemia del COVID-19 en ciudadanos de Trujillo- Perú. Material y Métodos: Tipo de estudio descriptivo, de enfoque cuantitativo y diseño correlacional, prospectivo, de corte transversal. Mediante un cuestionario previamente validado se tomaron datos de ciertos factores biológicos, sociales y culturales, así como de las actitudes y prácticas preventivas frente al COVID-19 en 185 ciudadanos de Trujillo. Por encontrarnos en cuarentena debido a la emergencia sanitaria, la recolección de datos se realizó de manera virtual. Resultados: Los resultados muestran que ciudadanos de 18 a 29 años tienen actitudes inadecuas (12.4%), con prácticas preventivas inadecuadas (8.6%) y también que ser de sexo masculino constituye un riesgo para tener actitud y practica inadecuada. También existen ciudadanos que son solteros o convivientes, no tienen hijos y tienen actitudes inadecuadas (14.1%) y prácticas inadecuadas (13%). Conclusiones: De los factores biológicos la edad y el sexo se asocian a las actitudes y prácticas preventivas frente a la pandemia, de los sociales, el estado civil y la tenencia de hijos se asocian a las actitudes y prácticas preventivas frente a la pandemia, y del cultural el tener conocimiento de la enfermedad y de las acciones a tomar se asocia con las prácticas preventivas frente a la pandemia del COVID-19.

ABSTRACT Objective: This research aims to analyze the relation between biological, social and cultural factors regarding the attitudes and preventive measures against COVID-19 among citizens of Trujillo-Peru. Material and Methods: This is a descriptive research, with a quantitative approach and a correlational, prospective and design. A previously validated questionnaire was used to collect certain biological, social and cultural data, as well as attitudes and preventive measures against COVID-19 among 185 citizens of Trujillo. Due to the quarantine and the Sanitary National Emergency, the collection of data was done by virtual means. Results: Citizens between 18 and 29 years old have inappropriate attitudes (12.4%) and inappropriate preventive measures (8.6%). Also, males have inappropriate attitudes and inappropriate preventive measures. Moreover, single citizens or unmarried couples without children have inappropriate attitudes (14.1%) and inappropriate practices (13%). Conclusions: Among biological factors, age and gender are related to attitudes and preventive measures regarding the pandemic. Among social factors, marital status and parenthood are related to attitudes and preventive measures regarding the pandemic. And among the cultural factor, knowledge of this disease and the measures to be taken are related to the preventive measures against COVID-19.

Factores asociados a la comisión del delito de extorsión en el Distrito Fiscal de La Libertad 2017-2018 / Factors Associated to Committing the Crime of Extortion in the Prosecution District of La Libertad, 2017-2018 / Fatores associados à prática do crime de exto de La Libertad 2017-2018

Resumen Este estudio se realizó con el objetivo de analizar qué factores están asociados a la comisión del delito de extorsión en el Distrito Fiscal de La Libertad- Perú. La metodología es cuantitativa, diseño descriptivo correlacional de corte transversal. Se revisaron 222 carpetas fiscales de las víctimas del delito de extorsión registradas de enero del 2017 a julio del 2018 en los distritos de Chepén y Trujillo. Asimismo, se encuestaron 523 personas que no fueron víctimas del delito de extorsión en los mismos distritos, dando un total de 745 participantes. Los resultados se determinaron aplicando el modelo de regresión logística, el cual muestra que, de los factores analizados, los factores sociales y económicos sí están asociados a la comisión del delito de extorsión, pero los factores biológicos no. Respecto a los factores sociales, el modelo establece que específicamente el estado civil y grado de instrucción son los que están asociados a la comisión del delito de extorsión. De los factores económicos analizados, el modelo establece que el nivel de ingresos, el lugar o zona de residencia y la tenencia de propiedades (vivienda y automóvil) están asociados a la comisión de este delito.

Abstract This study was performed to analyze the factors associated to committing the crime of extortion in the Prosecution District of La Libertad - Peru. For this purpose, the quantitative methodology was used, with a descriptive, cross-sectional and correlational design. Two hundred and twenty-two case files of victims of extortion were reviewed from January 2017 to July 2018 in the districts of Chepén and Trujillo. Furthermore, 523 people who were not victims of extortion in the same districts were interviewed, amounting to a total of 745 participants. The results were determined applying the logistic regression model, which demonstrated that, of the analyzed factors, the social and economic factors are associated to committing the crime of extortion, while biological factors are not. With respect to social factors, the model establishes that marital status and level of education are more specifically associated with the crime of extortion. Of the analyzed economic factors, the model establishes that level of income, place or area of residence and ownership of properties (housing and vehicles) are associated to this crime.

Resumo Este estudo foi realizado com o objetivo de analisar quais fatores estão associados à prática do crime de extorsão no Distrito Fiscal de La Libertad - Peru. A metodologia é quantitativa, descritiva e correlacionai de corte transversal. Foram revisados 222 processos fiscais de vítimas do crime de extorsão registrados de janeiro de 2017 a julho de 2018 nos distritos de Chepén e Trujillo. Da mesma forma, entrevistaram-se 523 pessoas que não foram vítimas do crime de extorsão nos mesmos distritos, dando um total de 745 participantes. Os resultados foram apurados aplicandose o modelo de regressão logística, que mostra que, dentro dos fatores analisados, os fatores sociais e económicos estão associados à prática do crime de extorsão, mas os biológicos não. Em relação aos fatores sociais, o modelo estabelece que especificamente o estado civil e o grau de escolaridade estão associados à prática do crime de extorsão. Dos fatores económicos analisados, o modelo estabelece que o nível de renda, o local de residência e a posse de bens (casa e carro) estão associados à prática deste delito.

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.