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Introduction: Transplacental infections are frequent, especially in developing countries, where limited screening is performed to find infectious agents in the pregnant population. We aim to determine the clinical and epidemiological characteristics and seroinfection of antibodies against Toxoplasma, parvovirus B19, T. pallidum, and HIV in pregnant women who attended the Motupe Health Center in Lambayeque, Peru during July-August 2018. Methods: A descriptive cross-sectional study was conducted in 179 pregnant women interviewed with a standardized questionnaire. ELISA was used to determine antibodies to Toxoplasma and parvovirus B19. The detection of syphilis and HIV was conducted using immunochromatography, while the detection of hepatitis B was conducted using FTA-ABS and immunofluorescence, respectively. Results: Of 179 pregnant women, syphilis and HIV infections routinely included in the screening of pregnant women presented a seroinfection of 2.2 and 0.6%, respectively. Toxoplasmosis seroinfection was 25.1%, while IgM antiparvovirus B19 was 40.8%, revealing that pregnant women had an active infection at the time of study. Conclusion: The level of seroinfection of toxoplasmosis reveals the risk to which pregnant women who participated in the study are exposed. The high seroinfection of parvovirus B19 could explain the cases of spontaneous abortion and levels of anemia in newborn that have been reported in Motupe, Lambayeque, Peru. However, future causality studies are necessary to determine the significance of these findings.
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Infecções por HIV , Parvovirus B19 Humano , Complicações Infecciosas na Gravidez , Sífilis , Toxoplasma , Toxoplasmose , Treponema pallidum , Humanos , Feminino , Gravidez , Peru/epidemiologia , Treponema pallidum/imunologia , Adulto , Estudos Transversais , Sífilis/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/virologia , Toxoplasmose/epidemiologia , Toxoplasmose/imunologia , Infecções por HIV/epidemiologia , Toxoplasma/imunologia , Adulto Jovem , Parvovirus B19 Humano/imunologia , Anticorpos Antiprotozoários/sangue , Anticorpos Antivirais/sangue , Adolescente , Estudos SoroepidemiológicosRESUMO
OBJECTIVES: To determine the association between internet addiction disorder (IAD) and anxiety and depressive symptomatology in high school students in two private schools in Chiclayo, Peru, during the COVID-19 pandemic. MATERIALS AND METHODS: Analytical cross-sectional investigation of 505 adolescents from two private schools. The dependent variables were anxiety and depressive symptomatology, measured with the Beck Adapted Depression Questionnaire (BDI-IIA) and the Beck Anxiety Inventory (BAI), respectively. The main independent variable was IAD, measured with the Internet Addiction Test instrument(IATI). Prevalence ratios (PR) and 95% confidence intervals (95%CI) were estimated. RESULTS: The average age was 14.16 years and 54.9% were women. 22.2% and 3.2% presented mild and moderate IAD; respectively. 9.3% presented severe anxiety and 34.3% severe depressive symptomatology. In the simple regression, adolescents with mild, moderate and severe IAD presented 19% (PR = 1.19; 95%CI: 1.05-1.35), 25% (PR = 1.25; 95%CI: 1.02-1.53) and 53% (PR = 1.47; 95% CI: 1.47-1.60) higher prevalence of depressive symptomatology; however, this association was not maintained in the multiple model. Anxiety increased 196% in adolescents with severe IAD (PR = 2.96; 95%CI: 1.86-4.71). CONCLUSION: We found that 2, 1, and 3 out of 10 students presented IAD, depressive symptomatology, and anxiety, respectively. We did not find an association between IAD and depressive symptomatology, but we did find an association with anxiety. Among the factors associated with the development of depressive symptomatology were the male sex, the presence of eating disorders, subclinical insomnia, using devices for more than 2 h, and using the Internet for academic activities. About anxiety, the associated factors are the female sex, the presence of eating disorders, subclinical insomnia, and the use of the Internet as social interaction. We recommend implementing counseling programs in view of the imminent introduction of the Internet as a pillar in education.
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Comportamento Aditivo , COVID-19 , Distúrbios do Início e da Manutenção do Sono , Adolescente , Humanos , Masculino , Feminino , Estudos Transversais , Transtorno de Adição à Internet/epidemiologia , Peru/epidemiologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Saúde Mental , Pandemias , COVID-19/epidemiologia , Estudantes/psicologia , Internet , Comportamento Aditivo/epidemiologia , Comportamento Aditivo/psicologia , Depressão/epidemiologia , Depressão/psicologiaRESUMO
BACKGROUND: During the COVID-19 pandemic, increased workload and stress could have increased mental health problems (anxiety and depression) in military personnel. However, the number of studies in military members is scarce, especially in regard to mental health. The objective of this study was determine the prevalence and factors associated with depression and anxiety in Peruvian military personnel. METHODS: We undertook an analytical cross-sectional study. The survey was distributed face to face between November 02 and 09, 2021, during the second wave of the COVID-19 pandemic among the military personnel. We used some instruments to measure depression (Patient Health Questionnaire, PHQ-9), anxiety (Generalized Anxiety Disorder, GAD-7), insomnia (Insomnia Severity Index, ISI), food insecurity (Household Food Insecurity Access Scale, HFIAS), physical activity (International Physical Activity Questionnaires, IPAQ-S), resilience (abbreviated CD-RISC), and fear of COVID-19 scale. The exclusion criteria included those who did not completely fill out the evaluation instruments. RESULTS: We analyzed the data of 615 military personnel that participated in the survey. Of them, 93.7% were male and the median age was 22 years old. There was a prevalence of 29.9% and 22.0% in regard to depression and anxiety symptoms, respectively. In addition, it was found that being married (PR: 0.63; 95% IC: 0.42-0.94), having a relative with mental health problems (PR: 2.16), having experienced food insecurity (PR: 1.48), insomnia (PR: 2.71), fear of COVID-19 (PR: 1.48), and a high level of resilience (PR: 0.65) were factors associated with depression. In regard to anxiety, the factors associated were working for more than 18 months since the beginning of the COVID-19 pandemic (PR: 0.52), a high level of resilience (PR: 0.50; 95% IC: 0.33-0.77), insomnia (PR: 3.32), fear of COVID-19 (PR: 2.43). CONCLUSION: We found a prevalence of symptoms of depression and anxiety of 29.9% and 22.0%, respectively. In regard to the factors that attenuate depression, we can mention being married and having resilience; and among the aggravating factors, having a relative with mental health problems, food insecurity, insomnia, and fear of COVID-19. Finally, anxiety increased through working time, insomnia, and fear of COVID-19.
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COVID-19 , Militares , Distúrbios do Início e da Manutenção do Sono , Humanos , Masculino , Adulto Jovem , Adulto , Feminino , COVID-19/epidemiologia , Pandemias , Estudos Transversais , Depressão/psicologia , Distúrbios do Início e da Manutenção do Sono/epidemiologia , Peru/epidemiologia , Ansiedade/psicologia , Transtornos de Ansiedade/epidemiologiaRESUMO
BACKGROUND: Costello syndrome (CS) is a rare genetic condition characterized by dysregulation of the signaling pathway, phenotypic alteration due to fetal macrosomia or growth retardation, facial abnormalities, loose skin, cardiovascular abnormalities, and a variable degree of intellectual disability. CASE PRESENTATION: We describe the case of a 20-month-old male patient with fetal macrosomia and polyhydramnios, presenting psychomotor development delay and growth limitation during the first months of life. CS was diagnosed at four months of age after detecting a variant of the HRAS gene c.35G > C (p.G12A). A clinical description of his condition was recorded throughout his life, including cardiovascular diseases, endocrine disorders, and recurrent infections. At 20 months of age, after presenting events of marked hypotonia and generalized seizures, brain magnetic resonance revealed symmetrical lesions of the infra- and supratentorial white matter in both cerebral hemispheres, which resulted in the diagnosis of cerebral leukodystrophy. The patient had a rapid and progressive deterioration that eventually led to death. CONCLUSIONS: This is the first report of a case of CS in Peru. In addition, this is a case that presented with multisystemic conditions culminating in leukodystrophy, which is a rare event according to the literature.
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Anormalidades Cardiovasculares , Síndrome de Costello , Deficiência Intelectual , Gravidez , Feminino , Humanos , Masculino , Lactente , Síndrome de Costello/complicações , Síndrome de Costello/diagnóstico , Síndrome de Costello/genética , Macrossomia Fetal , Genes ras , Deficiência Intelectual/genéticaRESUMO
Dengue virus and severe acute respiratory syndrome coronavirus 2 coexist in dengue-endemic countries; therefore, the adoption of preventive measures is essential to control the spread of both viruses. We conducted an ecological study to compare the temporal patterns of the incidence of dengue before and during the Coronavirus disease 2019 (COVID-19) pandemic in Peru. A time-series analysis comparing the incidence of dengue using a Student's t test with variance correction was performed. Poisson regression was applied to determine the incidence rate ratio (IRR) of dengue before and during the COVID-19 pandemic. The incidence of dengue was found to be increased in all endemic regions of Peru during the COVID-19 pandemic, with the highest incidences registered in Ica (IRR = 90.14), Huánuco (IRR = 38.6), and Ucayali (IRR = 23.78), with the exception of Piura (IRR = 0.83). The highest increases in the number of dengue cases per million inhabitants were in Ucayali (393.38), Tumbes (233.19), Ica (166.08), and Loreto (129.93). The gradient of dengue cases was positive in all endemic regions during the COVID-19 pandemic. The number of dengue cases per million increased during the COVID-19 pandemic throughout Peru and in several endemic regions, with the exception of Piura.
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COVID-19/epidemiologia , Coinfecção/epidemiologia , Dengue/epidemiologia , Vírus da Dengue/isolamento & purificação , Geografia , Humanos , Incidência , Peru/epidemiologia , SARS-CoV-2/isolamento & purificação , Doenças Transmitidas por Vetores/epidemiologiaRESUMO
Anti-N-methyl-D-aspartate receptor (anti-NMDAR) encephalitis presents commonly with psychiatric symptoms. One cohort of these patients reported that antipsychotic administration led to neuroleptic intolerance (NI) in 19% of them, which was preventable by a prompt encephalitis diagnosis. To date, there is no clear description of the "neuroleptic intolerance" spectrum in general or during anti-NMDAR encephalitis. We aimed to synthesize epidemiological and clinical characteristics of patients with NI and confirmed anti-NMDAR encephalitis, the time to the encephalitis diagnosis, the disease course, outcomes at discharge, and associated factors. We systematically searched three databases, to include clinical cases, case series, and observational studies. Additionally, we reported one clinical case. Results were summarized using narrative synthesis and the quality of the included studies was assessed. We included 22 records representing 40 patients (28 females; mean age, 24.6). Overall, the evidence quality was low. Initially, most cases were admitted in psychiatric wards (70%) with purely psychiatric symptoms (37.5%). However, most of them developed subtle concomitant neurological symptoms. The mean time to anti-NMDAR encephalitis diagnosis was 26.7 days, which was triggered by the NI in six patients. We found no association between clinical variables as delayed diagnosis, admission to psychiatric wards or the presence of malignancy with outcome variables as unfavorable outcomes at discharge, ICU, or mechanical ventilation requirement. A thorough neurological examination in young patients with new-onset psychiatric symptoms could help emergency physicians, neurologists, and psychiatrists suspect anti-NMDAR encephalitis earlier. Awareness of NI as a potential side effect during suspected or confirmed anti-NMDAR encephalitis is encouraged.
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Encefalite Antirreceptor de N-Metil-D-Aspartato , Antipsicóticos , Transtornos Mentais , Adulto , Encefalite Antirreceptor de N-Metil-D-Aspartato/complicações , Feminino , Humanos , Transtornos Mentais/complicações , Alta do Paciente , Receptores de N-Metil-D-Aspartato , Adulto JovemRESUMO
Introduction: Toxoplasma gondii infection can cause important complications during pregnancy. Threatened abortion may be a late indicator for infection in settings with high prevalence of toxoplasmosis. We aimed to determine the association between T. gondii infection and threatened abortion in women from northern Peru. Methods: We conducted a secondary analysis of a cross-sectional study in pregnant women from a hospital and a rural community in Lambayeque, Peru. Exposure variable was serological diagnosis of toxoplasmosis, defined as the demonstration of either IgM or IgG antibodies against T. gondii. Outcome variable was threatened abortion, defined as the diagnosis of bloody vaginal discharge or bleeding during the first half of pregnancy. Prevalence ratios were estimated in simple and multiple regression analyses. Results: Of 218 pregnant women, 35.8% presented positive serology for T. gondii and 14.7% had threatened abortion in their current pregnancy. Pregnant women with positive T. gondii infection had 2.45-fold higher frequency of threatened abortion (PR: 2.45, 95% CI: 1.15-5.21). In addition, the frequency of threatened abortion decreased by 9% for each additional year of age (PR: 0.91, 95% CI: 0.86-0.97). A previous history of threatened abortion also showed a higher frequency of threatened abortion (PR: 5.22, 95% CI: 2.45-11.12). Conclusions: T. gondii infection is associated with threatened abortion. An early age of pregnancy and a previous history of abortion are also associated with this condition.
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Ameaça de Aborto , Complicações Parasitárias na Gravidez , Toxoplasma , Toxoplasmose , Ameaça de Aborto/epidemiologia , Anticorpos Antiprotozoários , Estudos Transversais , Feminino , Humanos , Imunoglobulina M , Peru/epidemiologia , Gravidez , Complicações Parasitárias na Gravidez/epidemiologia , Fatores de Risco , Estudos Soroepidemiológicos , Toxoplasmose/complicações , Toxoplasmose/diagnóstico , Toxoplasmose/epidemiologiaRESUMO
Although knowledge on glycan biosynthesis and processing is continuously maturing, there are still a limited number of studies that examine biological functions of N-glycan structures in plants, which remain virtually unknown. Here, the statistical correlation between nutrient (nitrogen) deficiency symptoms of crops and changes in 8-aminopyrene-1,3,6-trisulfonic acid (APTS)-labeled complex type free oligosaccharides is reported. While deficiency symptoms are predicted by multispectral images and Kjeldahl digestion, APTS-labeled complex type free oligosaccharides are identified by their glucose unit (GU) values in tomato xylem sap, using capillary electrophoresis with laser induced fluorescence detection (CE-LIF). Given the limited number of structures obtained from plants, archived in the literature, in the future, it is intended to create an open access database of promising indicators, namely, glycan structures that are presumably responsible for the nutrient deficiency caused stress in plants (http://glycoplants.org).
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Eletroforese Capilar/métodos , Oligossacarídeos , Polissacarídeos , Solanum lycopersicum , Xilema/química , Glucose/análise , Glucose/química , Glicosilação , Solanum lycopersicum/química , Solanum lycopersicum/metabolismo , Solanum lycopersicum/fisiologia , Oligossacarídeos/análise , Oligossacarídeos/química , Polissacarídeos/análise , Polissacarídeos/químicaRESUMO
BACKGROUND: Peru has one of the highest mortality rates due to COVID-19 in the world. AIM: To describe the clinical features, evolution and explore factors associated with mortality in patients with moderate to severe Covid-19. MATERIAL AND METHODS: Prospective analytical study. The clinical, laboratory, imaging, and mortality data of patients admitted at a COVID service of the Santa Rosa de Piura Hospital were recorded from April to June 2020. RESULTS: Data from 391 patients with a median age of 60 years (70% women) was gathered. The time lapse between the onset of the disease and hospitalization was seven days. The most common alteration in the blood count was Neutrophilia in 78% of patients. The median PaO2/FiO2 ratio was 77. The distribution of tomographic patterns was Ground glass in 91% of patients, interstitial involvement in 57%, consolidation in 43%. Sixteen percent of patients had at least one complication, the most common was an increase in transaminases in 2%. Four percent were admitted to the intensive care unit and 53% died (94% during hospitalization and 5.8% during ICU stay). In the bivariate analysis, an association was found between a higher mortality and older age (p = 0.01), having fewer days of illness (p = 0.03), fewer days of hospital stay (p < 0.01), having at least one comorbidity (p = 0.02), lymphopenia (p = 0.02), neutrophilia (P = 0.03) and lower PaO2/ FiO2 ratio (p < 0.01). CONCLUSIONS: Fifty percent of these patients died. Age, rapid progression, having comorbidities and other laboratory alterations were associated with mortality.
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COVID-19 , Feminino , Hospitalização , Humanos , Tempo de Internação , Masculino , Pessoa de Meia-Idade , Peru/epidemiologia , Estudos ProspectivosRESUMO
Aim: To determine the frequency of physical activity and its association with chronic diseases in the elderly in eleven cities of Peru. Methods: A cross-sectional study of secondary data was conducted; the dependent variable was not the realization of physical activity, chronic disease and other physio-anthropometric variables were independent variables. For bivariate and multivariate analysis generalized linear models were used. A confidence level of 95% and p < 0.05 as statistically significant was considered. Results: Of the 1030 elderly 68% (698) did not perform physical activity. When performing the multivariate model was obtained for every year of age increased by 1.5% frequency do physical activity (RPA: 1.015, 95% CI 1.006-1.024, p = 0.001) for each additional centimeter waist decreased 0.6% performing physical activity (RPA: 0.994, 95% CI: 0.992-0.997, p < 0.001) and those suffering from other chronic heart disease (RPA: 1.15, 95% CI: 1.02-1.30. p = 0.019) had higher frequencies of no physical activity, adjusted for sex and city of residence. Conclusion: No physical activity was associated with suffering from some heart disease, older age and waist circumference. We need to consider these results from the study to promote physical activity in this population.
Objetivo: Determinar la frecuencia de actividad física y su asociación con enfermedades crónicas en ancianos de once ciudades del Perú. Métodos: Se realizó un estudio transversal analítico de datos secundarios. La variable dependiente fue la no realización de actividad física, y las independientes fueron las enfermedades crónicas y otras variables fisioantropométricas. Para el análisis bivariado y multivariado se usaron los modelos lineales generalizados. Se consideró un nivel de confianza del 95% y un valor de p < 0.05 como estadísticamente significativo. Resultados: De los 1030 ancianos, el 68% (698) no realizaba actividad física. Con el modelo multivariado se obtuvo que, por cada año de edad, aumentaba un 1.5% la frecuencia no hacer actividad física (razón de prevalencia ajustada [RPa]: 1.015; intervalo de confianza del 95% [IC 95%]: 1.006-1.024; p = 0.001); por cada centímetro de cintura adicional, disminuía un 0.6% la realización de actividad física (RPa: 0.994; IC 95%: 0.992-0.997; p < 0.001); y aquellos que padecían otra enfermedad cardiaca crónica (RPa: 1.15; IC 95%:1.02-1.30; p = 0.019) tenían mayores frecuencias de no realizar actividad física, ajustado por el sexo y por la ciudad de residencia. Conclusión: El no realizar actividad física se asoció con padecer alguna enfermedad cardiaca, mayor edad y el perímetro de cintura. Es necesario tener en cuenta estos resultados para promover la actividad física en esta población.
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Doença Crônica/epidemiologia , Exercício Físico , Cardiopatias/epidemiologia , Circunferência da Cintura/fisiologia , Fatores Etários , Idoso , Cidades , Estudos Transversais , Feminino , Cardiopatias/etiologia , Humanos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Peru/epidemiologia , Fatores de RiscoRESUMO
Tyrosine kinase inhibitors (TKIs) are the standard treatment for epidermal growth factor receptor mutant (EGFRm) advanced non-small cell lung cancer (NSCLC). Combining TKIs with an angiogenesis inhibitor has shown promise in pre-clinical studies. A systematic search of clinical trials found that combining erlotinib (a first-generation TKI) with bevacizumab or ramucirumab (angiogenesis inhibitors) improved progression-free survival (PFS) in EGFRm advanced NSCLC patients compared to TKI alone. However, no significant benefit in overall survival (OS) was observed in trials. Similar efficacy was seen in patients with specific EGFR mutations. Third generation TKIs were used as second-line therapy for patients with the T790M mutation. The combination treatment was associated with a higher incidence of severe adverse events. Overall, combining erlotinib or another TKI with an angiogenesis inhibitor is a safe and effective alternative for first-line treatment in EGFRm advanced NSCLC, particularly in countries without access to osimertinib and for patients with the EGFR L858R mutation.
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Carcinoma Pulmonar de Células não Pequenas , Neoplasias Pulmonares , Humanos , Angiogênese , Inibidores da Angiogênese/efeitos adversos , Inibidores da Angiogênese/uso terapêutico , Carcinoma Pulmonar de Células não Pequenas/tratamento farmacológico , Carcinoma Pulmonar de Células não Pequenas/genética , Receptores ErbB , Cloridrato de Erlotinib/efeitos adversos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Mutação , Inibidores de Proteínas Quinases/efeitos adversos , Inibidores de Proteínas Quinases/uso terapêuticoRESUMO
BACKGROUND: Decreasing emissions of the global healthcare sector will be an important tool for decreasing the magnitude of climate change. The environmental practices of nurses can have a positive environmental impact. The purpose of this study is to identify environmental practices performed by nurses while at work and home along with their associated factors. METHODS: This study is a cross-sectional descriptive study conducted by surveying nurses from two public hospitals in Lambayeque, Peru. We utilized the Nurses' Environmental Awareness Tool to collect information about nurses' knowledge on environmental impacts, their risk to health, and environmental behaviors at both work and home. RESULTS: Of the 106 participants who responded, the average age was 41 years, and 29 (28%) worked in surgical services. A little more than half of nurses reported appropriate energy use (51%) and recycling (53%) at work, while 94 (89%) implemented environmental biosafety. There was an observed association between age and years of employment with appropriate energy use, recycling, implementation of environmental biosafety, appropriate chemical substance use, and preventing medication waste. CONCLUSION: Nurses reported a favorable tendency toward adequate environmental practices at work and at home. However, more studies are needed to identify the factors that increase nurses' use of these practices. APPLICATIONS TO PRACTICE: As one of the most trusted professions, professional nurses have an opportunity to play a pivotal role in promoting environmental health and practices in both the workplace and their personal lives. This study highlights areas of potential intervention in the workplace to develop and promote appropriate environmental practices by nurses to decrease pollution by the healthcare sector.
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Competência Clínica , Enfermeiras e Enfermeiros , Humanos , Adulto , Peru , Estudos Transversais , Hospitais Públicos , Inquéritos e QuestionáriosRESUMO
Aim: We aimed to describe the neurosonological findings related to cerebral hemodynamics acquired using transcranial Doppler and to determine the frequency of elevated ICP by optic nerve sheath diameter (ONSD) measurement in patients with severe coronavirus disease (COVID-19) hospitalized in the intensive care unit of a national referral hospital in Peru. Methods: We included a retrospective cohort of adult patients hospitalized with severe COVID-19 and acute respiratory failure within the first 7 days of mechanical ventilation under deep sedoanalgesia, with or without neuromuscular blockade who underwent ocular ultrasound and transcranial Doppler. We determine the frequency of elevated ICP by measuring the diameter of the optic nerve sheath, choosing as best cut-off value a diameter equal to or >5.8 mm. We also determine the frequency of sonographic patterns obtained by transcranial Doppler. Through insonation of the middle cerebral artery. Likewise, we evaluated the associations of clinical, mechanical ventilator, and arterial blood gas variables with ONSD ≥5.8 mm and pulsatility index (PI) ≥1.1. We also evaluated the associations of hemodynamic findings and ONSD with mortality the effect size was estimated using Poisson regression models with robust variance. Results: This study included 142 patients. The mean age was 51.39 ± 13.3 years, and 78.9% of patients were male. Vasopressors were used in 45.1% of patients, and mean arterial pressure was 81.87 ± 10.64 mmHg. The mean partial pressure of carbon dioxide (PaCO2) was elevated (54.08 ± 16.01 mmHg). Elevated intracranial pressure was seen in 83.1% of patients, as estimated based on ONSD ≥5.8 mm. A mortality rate of 16.2% was reported. In the multivariate analysis, age was associated with elevated ONSD (risk ratio [RR] = 1.07). PaCO2 was a protective factor (RR = 0.64) in the cases of PI ≥ 1.1. In the mortality analysis, the mean velocity was a risk factor for mortality (RR = 1.15). Conclusions: A high rate of intracranial hypertension was reported, with ONSD measurement being the most reliable method for estimation. The increase in ICP measured by ONSD in patients with severe COVID-19 on mechanical ventilation is not associated to hypercapnia or elevated intrathoracic pressures derived from protective mechanical ventilation.
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INTRODUCTION: Depression is prevalent among aging people living with HIV (PLWH) worldwide. We sought to identify depression risk factors among a group of middle-aged and older PLWH in Lima, Peru. MATERIALS AND METHODS: We assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered. We performed descriptive statistics and logistic regression analyses. RESULTS: Mean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]). DISCUSSION: Our study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early mental health interventions.
Factors affecting depression in older people with HIV in PeruIntroductionDepression is common in older people living with HIV (PLWH) worldwide. We identified depression risk factors among a group of middle-aged and older PLWH in Lima, Peru.Materials and MethodsWe assessed risk factors for depression among PLWH over age 40 receiving care in an HIV clinic in Lima, Peru. The Patient Health Questionnaire-9 (PHQ-9) was administered.ResultsMean age was 51.7 ± 7.7 years with 15.3% females. One-quarter of participants had depression with higher frequency in females. Risk factors that significantly increased the risk of depression included female sex (adjusted prevalence ratio [aPR] = 2.19 [95%CI 1.07-4.49]), currently smoking (aPR = 2.25 [95%CI 1.15-4.43]), and prior opportunistic infection (aPR = 2.24 [95%CI 1.05-4.76]).DiscussionOur study demonstrates that PLWH who are female, current smokers, or had an opportunistic infection have higher risk of depression. Identifying PLWH at-risk for depression is key to early treatment or interventions that can improve mental health in PLWH in Peru.
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Depressão , Infecções por HIV , Humanos , Feminino , Peru/epidemiologia , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Infecções por HIV/epidemiologia , Infecções por HIV/psicologia , Infecções por HIV/complicações , Depressão/epidemiologia , Idoso , Prevalência , Adulto , Estudos Transversais , Fumar/epidemiologia , Fatores Sexuais , Modelos LogísticosRESUMO
Aim: To evaluate the biochemical and hematological markers associated with the risk of death due to COVID-19 in a clinical cohort with a severe clinical profile. Methods: A retrospective study was conducted among 215 anonymized inpatient records from the Hospital Nacional Almanzor Aguinaga Asenjo, Peru, between April and June 2020. The association between biomarkers and death due to COVID-19 was assessed using Cox regression, with a multivariable modeling of 1) biochemical and 2) hematological markers. Kaplan-Meier analyses and time-dependent receiver operating characteristic curves were calculated for each associated biomarker (p < 0.05). Results: Data analysis of 215 inpatient records revealed an overall mortality rate of 51.30% (95% CI 44.70-58.50), a mean age of 63.90 ± 14.10 years, and a median oxygen saturation of 88% (interquartile range 82-92%). The best-fitted biochemical model included higher levels of C-reactive protein (CRP), D-dimer, fibrinogen, urea, and lactate dehydrogenase. Similarly, the best-fitted hematological model included higher absolute neutrophil and prothrombin time, and lower absolute platelet counts. The best area under the curve values in both models were found to be CRP and D-dimer values (>0.74) and the absolute neutrophil count (0.63). Conclusions: Some specific biochemical markers outperformed hematological markers. Evaluated hematological counts analyzed in multivariable models proved to be better markers and could be useful to discriminate COVID-19 patients at high risk of death.
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Natural killer/T-cell lymphoma (NK/T-cellL) is an aggressive non-Hodgkin's lymphoma with limited treatment options for patients who experience disease progression or recurrence after second-line treatment. The use of new therapies, such as pembrolizumab, which involves immune checkpoint blockade mechanisms, is proposed. This systematic review followed the MOSE guidelines and searched PUBMED/MEDLINE, EMBASE, and Scopus databases. Fourteen articles were found, reporting on the use of pembrolizumab anti PD-1 in NK/T-cellL patients. The objective response rate was 84.50%, with disease-free survival ranging from two to 48 months. The complete response rate was 61.6%, and the quality of the reported studies was evaluated to be of high and moderate confidence bias levels in case reports and high bias in clinical trials. Pembrolizumab and others anti PD-1 are treatment options for refractory/recurrent NK/T-cellL, regardless of PD-L1 expression, with good short- and long-term results and low adverse events.
Assuntos
Linfoma não Hodgkin , Linfoma , Células T Matadoras Naturais , Humanos , Receptor de Morte Celular Programada 1 , Intervalo Livre de Doença , Antígeno B7-H1RESUMO
Booster vaccines are a strategy to mitigate the conditions in the health, social, and economic fields that the COVID-19 pandemic has brought. A series of adverse effects have been observed since the first vaccination. The present investigation aims to describe the short-term adverse effects of the fourth dose against COVID-19 in adults older than 40 from a region of Peru. The study population was over 40 years of age at the COVID-19 vaccination center in Trujillo, Peru. A 21-day follow-up was conducted from vaccination with the fourth dose, considering sex, age, body mass index, comorbidities, history of COVID-19 infection, vaccination schedule, and simultaneous vaccination against influenza as variables of interest. Multinomial logistic regression with robust variance was used to estimate the risk ratio (RR). In total, 411 people were recruited, and it was found that 86.9% of the participants presented adverse effects after injection with the fourth dose of the vaccine against COVID-19. Pain at the injection site was the most reported symptom after 3 days. Assessment of adverse effects after 3 days found that age ≥ 60 years was associated with a lower likelihood of adverse effects compared to those younger than 60 years (RRc: 0.32; 95% CI: 0.0.18-0.59), males compared to females were associated with a lower likelihood of adverse effects (RRc: 0.54; 95% CI 0.30-0.98), being overweight (RRc: 2.34; 95% CI: 1.12-4.89), and last vaccine with Pfizer-BioN-Tech (RRc: 0.42; 95% CI: 0.18-0.96). Associated adverse effects are mild to moderate. Injection site pain and general malaise are the most frequent adverse effects.
RESUMO
Introduction: During the COVID-19 pandemic, the mounting workload and heightened stress may contribute to exacerbated mental health challenges, including an increased fear of COVID-19, among military personnel. Despite the potential influence of these factors, there remains a scarcity of studies addressing mental health issues, particularly the fear of COVID-19, within this specific population. We aimed to determine the prevalence and factors associated with fear of COVID-19 among military members. Methods: A cross-sectional study was conducted between November 2 and 9, 2021, during the second wave of the COVID-19 pandemic in the Lambayeque region, Peru. The outcome variable was fear of COVID-19, assessed using the Fear of COVID-19 Scale. The association with resilience (Connor-Davidson Resilience Scale, abbreviated as CD-RISC), food insecurity (Household Food Insecurity Access Scale, abbreviated as HFIAS), physical activity (International Physical Activity Questionnaire-Short Form, abbreviated as IPAQ-S), eating disorder (Eating Attitudes Test-26, abbreviated as EAT-26), and other socio- demographic variables was assessed. Results: Among the 525 participants, the median age was 22, 95.8% were male, and 19.2% experienced fear of COVID-19. A higher prevalence of fear of COVID-19 was associated with age (PR=1.03; 95% CI: 1.01-1.06), religion (PR=2.05; 95% CI: 1.04-4.05), eating disorder (PR=2.95; 95% CI: 1.99-4.36), and having a relative with mental disorder (PR=2.13; 95% CI: 1.09-4.17). Overweight (PR=0.58; 95% CI: 0.37-0.90) and a high level of resilience (PR=0.63; 95% CI: 0.43-0.93) were associated with a lower prevalence of fear of COVID-19. Discussion: Two out of ten military personnel were afraid of COVID-19. Our results highlight the need for targeted interventions addressing the factors contributing to fear of COVID-19 among military personnel, emphasizing the significance of mental health support and preventive measures within this specific population.