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Introducción: Para policías y militares, el acceso a información idónea y veraz siempre ha sido importante; durante la pandemia la necesidad fue aún mayor debido a las labores que les fueron asignadas, como parte de la primera línea frente a la pandemia por la COVID-19. Objetivo: Determinar los factores asociados al miedo por la información recibida durante la pandemia en policías y militares peruanos. Métodos: Estudio transversal con técnicas analíticas, se encuestó a 1 017 policías y militares peruanos durante la pandemia, para ello se usó un test validado para medir la percepción de miedo o preocupación que transmitían los medios de comunicación, se informaron las frecuencias y resultados analíticos. Resultados: Los encuestados percibieron mucho miedo a las redes sociales (22 % muy de acuerdo y 36 % de acuerdo) y la televisión (20 % muy de acuerdo y 32 % de acuerdo). En el modelo multivariado, los militares percibían menos miedo en comparación de los policías (RPa: 0,65; IC95 %: 0,49-0,88; valor p= 0,004), además, internet fue el medio que generó una mayor frecuencia de percepción de miedo entre los encuestados (RPa: 1,65; IC95 %: 1,04-2,61; valor p= 0,032), ajustado por 3 variables. Conclusión: La televisión y las redes sociales son los principales medios que generaron miedo entre los policías y militares; además, el estar asustado estuvo más asociado a informarse por internet.
Introduction: For police and military, access to suitable and truthful information has always been important, during the pandemic the need was even greater due to the tasks assigned to them as part of the front line against the COVID-19 pandemic. Objective: To determine the factors associated with fear of pandemic information received by Peruvian police and military personnel. Methods: Cross-sectional study with analytical procedures, 1 017 Peruvian police and military were surveyed, through surveys conducted during the pandemic, a validated test was used to measure the perception of fear or concern transmitted by the media, the frequencies and analytical results were reported. Results: The respondents perceived a lot of fear of social networks (22% strongly agree and 36% agree) and television (20% strongly agree and 32% agree). In the multivariate model, the military perceived less fear compared to the police (aPR: 0.65; CI95%: 0.49-0.88; value p= 0.004), in addition, the Internet was the medium that generated a greater frequency of perception of fear among the respondents (aPR: 1.65; CI95%: 1.04-2.61; value p= 0.032), adjusted for 3 variables. Conclusion: Television and social networks are the main media that generate fear among police and military; in addition, being scared was more associated with being informed through the Internet.
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Resumen Introducción. De acuerdo con la Organización Mundial de la Salud, la tuberculosis multidrogorresistente (TB-MDR), definida como aquella en la que hay resistencia a isoniacida y rifampicina, representa una seria amenaza para la salud pública, ya que en 2018 se reportaron cerca de medio millón de nuevos casos de tuberculosis resistente a la rifampicina, de los cuales el 78% tenían TB-MDR. En Perú, 6 personas se enferman de tuberculosis (TB) cada hora y de los 27 000 casos notificados de enfermedad activa por año, el 10% corresponde a TB-MDR. Objetivo. Determinar la distribución geográfica de la TB-MDR y los factores de riesgo de esta enfermedad en la región de Junín, ubicada en el centro de Perú. Materiales y métodos. Estudio longitudinal retrospectivo de casos y controles que incluyó 3 602 personas con diagnóstico de tuberculosis confirmado con cultivo positivo para Mycobacterium tuberculosis entre enero y diciembre de 2016. Los casos fueron los pacientes con diagnóstico de TB-MDR y los controles, los demás pacientes. Resultados. Se encontró una mayor prevalencia de casos de TB-MDR en la selva central de Perú, zona con alta incidencia de TB. Al realizar el análisis multivariado, se encontraron los siguientes factores de riesgo de multidrogorresistencia: antecedente de tratamiento de la TB (OR: 1.61, IC95%: 1.14-3.26), fracaso del tratamiento previo (OR: 5.84, IC95%: 4.03-8.21) y contacto intradomiciliario con personas con TB-MDR (OR: 91.57, IC95%: 34.56-289.14). Conclusiones. La distribución geográfica de la TB-MDR es de tipo no heterogéneo con alta incidencia en la selva central. En pacientes con diagnóstico reciente de TB, se debe considerar la posibilidad de TB-MDR si presentan alguno de los factores de riesgo identificados aquí y proceden de alguna zona de alta prevalencia de esta enfermedad.
Abstract Introduction: According to the World Health Organization, multidrugresistant tuberculosis (MDR TB), defined as TB cases in which there is resistance to rifampicin and isoniazid, is a serios threat for public health, since nearly half million new cases of rinfampicin-resistant TB were reported in 2018, of which 78% were MDR TB. In Peru, 6 people fall ill with tuberculosis (TB) every hour and out of the 27 000 active TB cases reported per year, 10% are MDR TB cases. Objective: To determine the geographical distribution of MDR TB and the risk factors of this disease in the Junín region, located in central Peru. Materials and methods: Retrospective longitudinal case-control study. The study population consisted of 3 602 people with TB diagnosis confirmed with positive cultures for M. tuberculosis between January and December 2016. Cases were made up of patients diagnosed with MDR TB, and the remaining patients were the controls. Results: A higher prevalence of MDR-TB cases was observed in the central jungle of Peru, an area with a high incidence of TB. After performing the multivariate analysis, the following risks factors for developing multidrug resistance were found: history of TB treatment (OR: 1.61, 95%CI: 1.14-3.26), prior treatment failure (OR: 5.84, 95%CI: 4.03-8.21) and intra-household contact with people with MDR-TB (OR: 91.57, 95%CI: 34.56-289.14). Conclusions: The geographical distribution of MDR TB is non-heterogeneous and has a high incidence in the central jungle. In the case of patients recently diagnosed with TB, the possibility of MDR TB diagnosis should be considered if they have at least one of the risk factors identified here and come from an area where this disease is highly prevalent.
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INTRODUCTION: Endothelial function at high altitude has been measured only in populations that are genetically adapted to chronic hypoxia. The objective of this study was to evaluate endothelial dysfunction (ED) in a nongenetically adapted high-altitude population of the Andes mountains, in Huancayo, Peru (3,250 meters above sea level). METHODS: Participants included 61 patients: 28 cases and 33 controls. The cases were subjects with hypertension, diabetes mellitus, obesity, or a history of stroke or coronary artery disease. Flow-mediated vasodilation (FMD) of the brachial artery was measured in the supine position, at noon, after 5 minutes of resting. The brachial artery was identified above the elbow. Its basal diameter was measured during diastole, and FMD was tested after 5 minutes of forearm ischemia. Intima-media complex in the right carotid artery was also determined. An increase in the artery's baseline diameter <10% indicated a positive test. Endothelium-independent vasodilation was evaluated with sublingual nitrate administration. The intima-media complex in the right carotid artery was also measured. RESULTS: 100% of diabetics had ED; ED was also found in 68.8% of obese individuals, 55% of hypertensive patients, and 46.5% of controls. Age, height, body mass index, and waist diameter were higher in the cases as compared with the controls. A total of 57.9% (n=11) of the cases and 45.2% (n=19) of the controls presented ED. Patients without ED had a mean increase in brachial artery diameter of 23.16%, while in those with ED it was only 3.84%. Individuals with diabetes or hypertension had a greater thickness of the carotid artery intima media layer (1.092 versus 0.664 cm) (p=0.037). A positive test for ED was associated with a greater basal diameter of the brachial artery (4.66±0.62 versus 4.23±0.59 cm) (p=0.02). A total of 7 patients presented paradoxical response, developing posthyperemia vasoconstriction. DISCUSSION: The proportion of ED was high among controls and among patients with risk factors. Controls showed better FMD profiles than subjects studied in Tibet and the Himalayas.