South American Validation of a Survey to Assess Eco-Anxiety in Adults (ECO-ANS-LATAM).

Background: climate change is a reality, and more and more people are becoming aware of this global problem, which has generated anxiety in some populations. To validate a short survey to assess eco-anxiety in adults in South America. Methods: It is an instrumental study, and the validation was based on a previous survey, which had six questions and was generated by 217 respondents in the USA in 2021. These questions were subjected to a validation process with expert judgment, pilot and application, and then statistics were obtained. It was validated with 1907 people in six countries in South America, where the mean, standard deviation, skewness and kurtosis were adequate. Results: The initial confirmatory factorial model obtained unsatisfactory goodness-of-fit indices, so the indices were modified through a re-specification, where two items were eliminated, after which adequate values were obtained (χ2 = 22.34, df = 2, p = 0.00; RMR = 0.020; GFI = 0.990; CFI = 0.990; TLI = 0.990; and RMSEA = 0.070). Finally, the overall Cronbach's α was calculated to be 0.88 (95% CI = 0.86-0.89). Conclusions: The test was validated in a large South American population and found that only four questions can efficiently measure anxiety about the effects of climate change. The instrument can be used with other tests to screen different age groups, ethnicities and realities.

Crisis due to war: anxiety, depression and stress in the population of 13 Latin American countries.

Sustainability may be at risk in a population that has altered health, according to Sustainable Development Goal 3 (SDG 3): Health and well-being. The ongoing conflict between Russia and Ukraine could jeopardize SDG 3, specifically the mental health of the population. The present study sought to determine the association between severe anxiety, depression and stress in population of 13 Latin American countries according to fear about the war conflict. It was a cross-sectional, analytical and multicenter study. Anxiety, depression and stress were measured with the DASS-21 test (Cronbach's Alpha: 0.97) and fear due to an armed crisis with a questionnaire already validated in Latin America (Cronbach's Alpha: 0.92), which was also adjusted for sex, age, education level and country of residence. Descriptive and analytical statistics were obtained. Of the 2,626 respondents, the main fear was that weapons of mass destruction would be used. In the multivariate models, strong associations were found between fear of a possible world-scale armed conflict and having severe or very severe levels of anxiety (aPR: 1.97; 95% CI: 1.64-2.36; value of p <0.001), depression (aPR: 1.91; 95% CI: 1.54-2.36; value of p <0.001) or stress (aPR: 2.05; 95% CI: 1.63-2.57; value of p <0.001). Sustainability linked to SDG 3, specifically mental health, is affected by this type of significant events, given the possible global war crisis that could trigger major events, even more so if added to the deterioration already experienced by COVID-19 in the Latin American region, insecurity and constant political uncertainty.

Post-Traumatic Stress Associated with Telework-Related Job Limitation in Latin America.

During the pandemic, there has been evidence of work limitations during telework, which are believed to cause mental health problems. Our objective was to assess the association between perceived work limitations during telework and posttraumatic stress during the COVID-19 pandemic in Latin America. A cross-sectional study was conducted in Latin America in 2020. Exposure was measured by self-reporting using a self-perception questionnaire; the SPRINT-E questionnaire was used for outcome measurements. Generalized linear models were applied. Of 1329 participants, 15.2% (n = 202) had posttraumatic stress. In a multivariate analysis, the highest frequency of posttraumatic stress was found among those with moderate depression or more (PR = 1.29; 95% CI: 1.03-1.61), moderate or more anxiety (PR = 2.34; 95% CI: 1.61-3.41), and moderate or more stress (PR = 2.45; 95% CI: 1.46-4.12). In conclusion, there is an association between perceived work limitations during telework and posttraumatic stress in Latin American workers. For this reason, it is recommended that occupational physicians, companies, and institutions assess the frequency of posttraumatic stress and monitor the mental health of workers.

[Analysis with Google Trends and Our World in Data on Global Mental Health in the Context of the covid-19 Pandemic]. / Análisis con Google Trends y Our World in Data sobre la salud mental mundial en el contexto de la pandemia por covid-19.

Introduction: During the covid-19 pandemic, mental health services were unable to cope with the high demand from the population, so many people chose to search the Internet for information that could help them cope with the psychological process they were experiencing at the time. The aim of this study was to characterize the global search trend for the term «psychiatry¼ in the context of covid-19 using Google Trends and Our World in Data. Methods: Descriptive-cross-sectional study on global search trends for Psychiatry in the context of covid-19 under the terms «psychiatry¼, «depression¼, «anxiety¼, «stress¼, «insomnia¼ and «suicide¼ in the category of health, this was conducted over the period 2020-2021 and time graphs were generated. Results: The term «psychiatry¼ remained at a consistently high relative search volume (between 60 and 90), with a significant and gradual search in the month of April. The relative search volume for «depression¼, «anxiety¼ and «stress¼ remained constant with some non-significant fluctuations over the period 2020-2021. The term «insomnia¼ was predominant between January and June 2020, gradually declining in April and remaining constant until October 2021. Finally, the term «suicide¼ had a fluctuating RBV between 60 and 100 during this period. Conclusions: During the study period, the topics related to mental health and the speciality of psychiatry remained constant, with some fluctuating, but not outstanding variations.

Factores asociados a la percepción de repercusiones del internado hospitalario peruano durante la COVID-19

Introducción: La pandemia afectó el internado de estudiantes de salud en su asistencia hospitalaria, en la cual realizan las prácticas. Objetivo: Determinar los factores asociados a la percepción de repercusiones del internado hospitalario peruano durante la COVID-19. Métodos: Estudio transversal; se obtuvo estadística descriptiva, analítica bivariada y multivariada basado en una encuesta realizada de forma exploratoria, como parte de otra investigación mayor, a la cual se le asoció variables como edad, sexo, tipo de universidad, estrés, ansiedad, depresión y repercusiones del internado. Resultados: De los 121 encuestados, la mayoría pensó que su familia le hubiese apoyado si se enfermaba de gravedad, que pudo haber infectado a sus familiares o alguna amistad/conocido si acudían al hospital. Muchos estuvieron en desacuerdo con que el hospital o la universidad les darían los implementos de seguridad, por la falta de apoyo de estas entidades. Hubo asociación entre el pensar que se habría contagiado de la COVID-19 si iba al hospital versus el puntaje de ansiedad (p= 0,030), el sexo masculino, según la percepción de que la universidad les daría los materiales para cuidarse (p= 0,029) y el provenir de una universidad privada según el percibir que el hospital no le hubiese apoyado, si se enfermaba de gravedad (p= 0,049). Conclusión: Los factores asociados a la percepción de repercusiones del internado son el apoyo familiar, el poder contagiar a sus familiares, falta de materiales dados por las universidades y hospitales, la ansiedad, el sexo masculino y provenir de universidades privadas.

Introduction: The pandemic affected the internship of health sciences students when they attended the hospital. Objective: To determine the factors associated with the perceived impact of the Peruvian hospital internship during COVID-19. Methods: Cross-sectional; descriptive, bivariate analytical and multivariate statistics were obtained based on an exploratory survey conducted as part of a larger investigation, to which variables such as age, sex, type of university, stress, anxiety, depression, and repercussions of the internship were associated. Results: Of 121 respondents, most of them thought that family would have supported if they have gotten a severe disease. Also, they thought that they could have infected their families or friends/acquaintances if they have gone to the hospital. Many of them disagreed on the statement about the hospital or university providing them safety implements. There was an association between thinking that they could have gotten COVID-19 if they have gone to the hospital versus anxiety score (p= 0,030), being a male according to the perception that the university provided materials to take care of themselves (p= 0,029), and having studied in a private university according to perceiving that the hospital would not have supported them if they have gotten seriously ill (p= 0,049). Conclusion: The factors associated with the perception of repercussions of the boarding school are family support, being able to infect their acquaintances, lack of materials provided by universities and hospitals, anxiety, being male, and coming from private universities.

Prevalence of post-traumatic stress disorder risk post-COVID-19 in 12 countries in Latin America: a cross-sectional survey.

Introduction: Latin America was the region most affected by COVID-19 in the second quarter of 2020, and consequently, the impact on mental health requires evaluation. The aim of this study was to assess the risk of post-traumatic stress disorder (PTSD) caused by bereavement due to COVID-19 in 12 countries in Latin America. Methods: The current study was an analytical cross-sectional study. Validated tests were applied for PTSD, depression, anxiety, and stress (DASS-21), questions about the respondent's condition or their environment, and demographic questions, as well as the length of the mourning period of suffering. Results: The outcomes demonstrated that the PTSD risk increased for women (p < 0.001), when a friend or acquaintance had COVID-19 (p = 0.002), when a close relative died from COVID-19 (p = 0.010), having severe depression (p <0.001), severe anxiety (p <0.001), severe stress (p <0.001), residing in Chile (p <0.001), Paraguay (p <0.001), Bolivia (p <0.001), Costa Rica (p <0.001) or El Salvador (p = 0.005). On the other hand, there was less risk of PTSD at an older age (p <0.001) or if respondents had a sentimental partner (p = 0.025). In the case of severe PTSD, there was a greater gender risk for women (p <0.001), a close relative dying from COVID-19 (p = 0.017), having severe depression (p <0.001), severe anxiety (p <0.001), severe stress (p <0.001), residing in Chile (p <0.001), Paraguay (p <0.001), Bolivia (p <0.001) and Costa Rica (p = 0.002). It was also observed that there was less risk of severe PTSD at an older age demographic (p <0.001). Discussion: It can be concluded that the percentages of PTSD are high in its clinical presentation as severe, especially among Latin American women.

Factores asociados a preocupación y miedo durante la COVID-19 en practicantes preprofesionales de salud

RESUMEN Introducción: Los practicantes preprofesionales de la salud también fueron afectados mentalmente por la COVID-19. Objetivos: Determinar los factores asociados a tener más preocupación y miedo durante la COVID-19 en practicantes preprofesionales de la salud peruanos. Métodos: Estudio transversal con métodos analíticos; participaron 285 estudiantes de diferentes carreras de la salud del sur del Perú; les fueron aplicados 2 test validados localmente, a los resultados se les cruzó con diversas variables socio-educativas. Resultados: Las principales preocupaciones fueron: no podían evitar preocuparse a pesar de las medidas tomadas, incertidumbre por ser una enfermedad impredecible, que su centro laboral tiene muchos riesgos y la percepción de que su capacidad laboral fuera afectada por ser contagiado. Los principales miedos fueron: percepción de que el corazón se aceleraba o que las manos le suden. Quienes se encontraban en algún establecimiento I-3 (sin internamiento) tenían menos preocupación que los de otros (RPa: 0,56; IC 95 %: 0,43-0,72; valor p< 0,001), ajustado por el sexo y la carrera de estudios. A mayor edad había más miedo (RPa: 1,76; IC 95 %: 1,46-2,11; valor p< 0,001), ajustado por 4 variables. Conclusiones: Los practicantes evidenciaron preocupación en relación a lo impredecible que es la enfermedad, riesgos laborales y el poder ser contagiado; además, miedo que causó una aceleración cardiaca muy fuerte y sudor en las manos. Asociado a la preocupación estuvo el nivel del establecimiento de la salud en donde laboraban y asociado al miedo, la edad de los encuestados.

ABSTRACT Introduction: Preprofessional health care practitioners were also mentally affected by COVID-19. Objectives: To determine the factors associated with having more worry and fear during COVID-19 in Peruvian pre-professional health care practitioners. Methods: Cross-sectional study with analytical methods, with the participation of 285 students from different health careers in southern Peru, to whom 2 locally validated tests were applied and crossed with different socio-educational variables. Results: The main concerns were that they could not help worrying despite the measures taken, the uncertainty of being an unpredictable disease, the fact that their workplace has many risks and the perception that their ability to work would be affected by being infected. The main fears were the perception that their heart was racing or that their hands were sweating. Those who were in an I-3 facility (without hospitalization) were less worried than those in other facilities (RPa: 0.56; 95 % CI: 0.43-0.72; p-value< 0.001), adjusted for sex and educational career. In addition, the older the age, the more fear (RPa: 1.76; 95 % CI: 1.46-2.11; p-value< 0.001), adjusted for 4 variables. Conclusions: The practitioners showed concern in relation to the unpredictability of the disease, occupational hazards and the fact that they could be infected; in addition, fear that caused a very strong cardiac acceleration and sweating in the hands. Associated with the concern was the level of the health facility where they worked. Associated with fear was the age of the respondents.

Factores socio-laborales asociados a la posibilidad de vacunación contra la COVID-19 si el trabajo se los exige, Perú / Socio-occupational factors associated with the possibility of vaccination against COVID-19 if required by work, Peru

En el contexto de la llegada de las vacunas contra la COVID-19 al Perú, es importante conocer que rubros son los más dispuestos a realizarlo. El objetivo de este estudio fue determinar los factores socio-laborales asociados a la posibilidad de vacunación contra la COVID-19 si el trabajo se los exige. Estudio transversal analítico, que tuvo como pregunta principal si es que se vacunarían si es que es requisito para el trabajo, esto se comparó según el rubro laboral, el sexo y el grupo etario; se obtuvo estadística descriptiva y analítica. De los 6628 trabajadores encuestados, el 34% y 35% se vacunarían si es que el trabajo se los pide según el que aún no se enfermaran o que ya lo hubiesen hecho, respectivamente. En el análisis multivariado, hubo mayor frecuencia de estar de acuerdo con el vacunarse entre los que están en el sector de minería (RPa: 1,33; IC95%: 1,05-1,69; valor p=0,019), los que hacen labores domésticas (RPa: 1,14; IC95%: 1,01-1,29; valor p=0,036) y los hombres (RPa: 1,07; IC95%. 1,01-1,14; valor p=0,029); en cambio, a comparación de los más jóvenes, los del rango etario de 40-49 años (RPa: 0,82; IC95%: 0,71-0,95; valor p=0,010) los que pensaban en vacunarse menor frecuencia. Hubo una baja percepción a la posibilidad de vacunarse si es que el trabajo se los pide, siendo los principales factores asociados a la posibilidad de vacunarse el no haberse contagiado previamente de COVID-19, pertenecer al sector minería, realizar labores domésticas y ser hombre(AU)

In the context of the arrival of vaccines against COVID-19 in Peru, it is important to know which sectors are the most willing to be vaccinated. The objective of this study was to determine the socio-labor factors associated with the possibility of vaccination against COVID-19 if required by work. Analytical cross-sectional study, which had as its main question whether they would be vaccinated if it was a job requirement, this was compared according to work category, sex and age group; descriptive and analytical statistics were obtained. Of the 6628 workers surveyed, 34% and 35% would get vaccinated if required to do so by their job, based on whether they had not yet been sick or had already been sick, respectively. In the multivariate analysis, there was a higher frequency of agreement to be vaccinated among those in the mining sector (aPR: 1.33; 95%CI: 1.05-1.69; p-value=0.019), those doing domestic work (aPR: 1.14; 95%CI: 1.01-1.29; p-value=0.036) and men (aPR: 1.07; 95%CI. 1.01-1.14; p-value=0.029); in contrast, those in the younger age range 40-49 years (aPR: 0.82; 95%CI: 0.71-0.95; p-value=0.010) were less likely to be vaccinated than those in the younger age range (aPR: 0.82; 95%CI: 0.71-0.95; p-value=0.010). There was a low perception of the possibility of getting vaccinated if asked to do so at work, the main factors associated with the possibility of getting vaccinated being not having been previously infected with COVID-19, belonging to the mining sector, performing domestic work and being male(AU)

[Supernumerary spleen simulating a renal tumor. Case report]. / Bazo supernumerario simulando un tumor renal: a propósito de un caso.

OBJECTIVE: Report one case of ectopic spleen simulating a renal tumor. We performed a review of etiopathogenesis, diagnosis and treatment. METHODS: We present the case of a 54-year-old splenectomized female patient with the incidental diagnosis on ultrasound of a left kidney upper pole mass simulating a renal tumor. RESULTS: After the performance of CT scan, and with the suspicion of renal neoplasia, the patient underwent tumorectomy with the pathologic diagnosis of the specimen compatible with supernumerary spleen. CONCLUSIONS: We emphasize the importance of including pseudo masses of splenic origin in the differential diagnosis of left renal, adrenal and retroperitoneal tumors. We emphasize the importance of CT scan as the imaging test of choice, and gammagraphy as a complementary test. We point out conservative attitude as the most suitable in cases of asymptomatic pseudomass of splenic origin.

[Idiopathic scrotal edema: report of two cases]. / Edema del escroto agudo idiopático: presentación de dos casos.

OBJECTIVE: To report two cases of acute idiopathic scrotal edema. METHODS: We describe the cases of two 12-year-old male patients presenting at the emergency department of our hospital with pain, edema and erythema in one hemiscrotum without history of trauma. RESULTS: On physical examination both patients showed red hemiscrotum skin and increase of the size with normal testicles and epididymis. With the diagnosis of acute scrotum testicular ultrasound were performed and showed heterogeneous edema of the scrotal skin with increased in Doppler flows and normal testicles. CONCLUSIONS: Acute idiopathic scrotal edema is a self-limited pathology which basically affects children before puberty and should be included in the differential diagnosis of acute scrotum to avoid aggressive interventions.

[Bilateral synchronic testicular tumor with germ cell intratubular neoplasia foci: case report]. / Tumor testicular bilateral sincrónico con focos de neoplasia intratubular de células germinales: presentación de un caso.

OBJECTIVE: To report one case of bilateral synchronic testicular tumor with germ cell intratubular neoplasia foci affecting both testicles. METHODS: We describe the case of a 29-year-old male presenting with a painless tumor in the left testicle for a month. With the suspect of testicular tumor scrotal ultrasound, tumor markers and extension study to rule out metastasis were performed. RESULTS: Ultrasound showed a hypertrophic left testicle with a lesion suspect for neoplasia, and incidental diagnosis of a hypoechoic lesion with augmented Doppler flow within the right testicle. Bilateral orchyectomy was performed with the pathologic diagnosis of classic seminoma with germ cell intratubular neoplasia foci in both testicles. Treatment was completed with two cycles of chemotherapy. CONCLUSIONS: Bilateral synchronic testicular tumors are very rare. The most frequent histological type is classic seminoma. The diagnosis and treatment are similar to unilateral testicular tumors except certain cases in which partial excision of the testicle may be considered.

[Results of the surgical treatment of benign prostatic hyperplasia in geriatric patients]. / Resultados del tratamiento quirúrgico de la patología prostática benigna en pacientes geriátricos.

OBJECTIVES: To evaluate the effect of age in morbidity-mortality and outcomes of the surgical treatment of benign prostatic hyperplasia (BPH). METHOD: We performed a retrospective analysis of the medical records of 305 patients over 70 years undergoing surgery for BPH between 1999-2003, grouped in four categories depending on ages 70-80 years and over 80, and type of surgery (transurethral resection or open prostatectomy). The variables evaluated were: American society of anesthesiologists (ASA) operative risk classification, surgical indication, preoperative factors, postoperative outcome and follow-up. Statistical analysis was carried out with the Anova and chi-square tests (p = 0.05). RESULTS: Open prostatectomy was performed in 59.1% of the cases and transurethral resection in the other 40.9%. 98.4% of the patients showed some degree of comorbidity. Indwelling transurethral catheter was the main clinical feature of patients undergoing surgery over 80 years of age; the main characteristic in patients between 70-80 years was the existence of severe symptoms. Urological complications appeared more frequently than general complications (14% vs. 10.1%). The most frequent urological complications were mild, mainly inflammatory-infectious diseases. Urological and general complications were more frequently observed in the open prostatectomy group, with no differences between ages. Patient satisfaction was high in the four groups (84.8%-96.2%). No case of perioperative mortality happened and only one patient died in the immediate post operative period. CONCLUSIONS: We think the differences observed cannot be attributed to chronological age as clinical risk factor. Therefore, these patients could benefit of a definitive surgical treatment which will improve their quality of life.

[Bladder leiomyosarcoma. Case report]. / Leiomiosarcoma vesical. Aportación de un nuevo caso.

OBJECTIVE: We report a new case of bladder leiomyosarcoma in a young female patient. We review its features and different treatment options. METHODS: The patient underwent neoadyuvant chemotherapy and surgical excision. RESULTS: A partial response was achieved with neoadyuvant chemotherapy and remains still alive 60 moths after radical cystectomy CONCLUSION: Despite the poor prognosis of this disease, multimodal treatment may improve results. Neoadyuvant chemotherapy and subsequent radical excision could be a good combination therapy for these aggressive tumors.

[Fournier's gangrene]. / Gangrena de Fournier.

OBJECTIVES: We report a retrospective review of the case series of Fournier's gangrene treated in our department from November 1996 to October 2004. METHODS/RESULTS: We studied nine male patients with ages between 21 and 85 years (mean 55 years). 66% of the patients had associated risk factors, and the underlying cause was identified in 56% of the cases. Mean hospital stay was 21 days and two of the patients died from the disease. CONCLUSIONS: Fournier's gangrene is an infection with a very fast evolution, producing necrotizing fascitis of the external genitalia and perineum. It has a high mortality rate, mainly if diagnosis and treatment are deferred. This last includes wide spectrum antibiotic coverage, surgical treatment with debridement and drainage, and, in many cases, a second surgical intervention for reconstructive plasties.

[Solitary fibrous tumor of the tunica vaginalis testis]. / Tumor fibroso solitario de la túnica vaginal.

OBJECTIVES: We report one case of solitary fibrous tumor of the tunica vaginalis, a benign paratesticular lesion. METHODS: Surgical exploration with intraoperative biopsy and excision of the lesion was undertaken, leaving the testicle and epididymis undamaged. RESULTS: Intraoperative biopsy revealed the presence of fibrous tissue without malignant cellularity. Pathological diagnosis on the surgical specimen was solitary fibrous tumor of the tunica vaginalis. The patient remains asymptomatic and disease-free one year after treatment. CONCLUSIONS: Almost all testicular masses are malignant, but in order to avoid a non-indicated orchyectomy, one should be cautious with the finding of a paratesticular lesion of probable benign nature on ultrasound or during surgery.

[Migration of an intrauterine contraceptive device into the urinary bladder: report of one case]. / Migracion intravesical de un dispositivo intrauterino: presentacion de un caso.

OBJECTIVES: To report one case of uterine perforation and migration into the urinary bladder of an intrauterine contraceptive device. METHODS/RESULTS: 42-year-old female patient who presents with lower urinary tract irritative syndrome in association to recurrent urinary tract infection. Ultrasound revealed apart of an intrauterine device inside the bladder, device which was inserted years before and was supposed to have come out spontaneously. Urethrocystoscopy with extraction of the intravesical segment and hysteroscopy with extraction of the intrauterine segment were carried out. CONCLUSIONS: The postoperative period was satisfactory and patient is currently asymptomatic. Radiological or ultrasound controls should be performed in the follow-up of patients with intrauterine contraceptive devices. The inability to locate an intrauterine contraceptive device in a patient who did not realize it coming out should be considered an uterine perforation until proved otherwise.