Use of ivermectin and factors associated with the prevention and/or treatment of COVID-19: a cross-sectional online survey in the province of Chincha, Peru.

Background: Peru has reported one of the highest mortality rates from COVID-19 worldwide. The Chincha province has been one of the most affected regions in Peru and the leading promoter of the use of ivermectin for the treatment of COVID-19. Therefore, our study aimed to evaluate the frequency of use and factors associated with the use of ivermectin for COVID-19 in Chincha. Methods: A cross-sectional study was conducted during the second wave of COVID-19 in Peru. For statistical analyses, frequencies and percentages were reported. Prevalence ratios (PR) with a 95% confidence interval (CI), and a p-value of 0.05 were used to determine statistical significance. SPSS version 22 (IBM Corp) program was used for the analyses. Results: A total of 432 participants were included in the study. A total of 67.6% (n = 292) of the participants used ivermectin during the COVID-19 pandemic. Of these, 20.20% (n=59) of the people used ivermectin for prophylactic purposes only, while 41.79% (n=122) used it as treatment for COVID-19 only, and 38.01% (n=111) used it for both reasons. The consumption of ivermectin was associated with being 50 years or older (PR:1.27, 95% CI:1.04-1.54), having a technical education level (PR:1.16, 95% CI:1.01-1.34), having had symptoms of COVID-19 with negative/no diagnosis (PR: 1.28, 95% CI: 1.07-1.53) or positive diagnosis (PR:1.38, 95% CI:1.18-1.61), or having had contact with infected people (PR:1.45, 95% CI:1.06-1.98). Conclusions: Most people in Chincha used ivermectin during the second wave of the COVID-19 pandemic. The main factors associated with the use of ivermectin for the prevention/treatment of COVID-19 were age ≥50 years, having a technical education level, having had symptoms with negative/no diagnosis or positive diagnosis, and contact with people infected with SARS-CoV-2.

Compliance with Antibiotic Prophylaxis in Obstetric and Gynecological Surgeries in Two Peruvian Hospitals.

INTRODUCTION: Surgical site infections (SSI) can be as high in gynecology and obstetrics surgeries compared to other areas. Antimicrobial prophylaxis is an effective tool in the prevention of SSIs; however, it is often not adequately administered, so this study aimed to understand the compliance and factors associated with the use of the clinical practice guidelines for antibiotic prophylaxis in gynecological surgeries in two hospitals in the city of Huanuco, Peru. METHODS: An analytical cross-sectional study of all gynecologic surgeries performed during 2019 was performed. Compliance was determined based on the antibiotic chosen, dose, administration time, redosing, and prophylaxis duration. Age, hospital of origin, presence of comorbidities, surgery performed, as well as its duration, types of surgery, and anesthesia were considered as related factors. RESULTS: We collected 529 medical records of patients undergoing gynecological surgery with a median age of 33 years. The prophylactic antibiotic was correctly indicated in 55.5% of cases, and the dose was correct in 31.2%. Total compliance with the five variables evaluated was only 3.9%. Cefazolin was the most commonly used antibiotic. CONCLUSION: Low compliance with the institutional clinical practice guidelines for antibiotic prophylaxis was identified, showing that antimicrobial prophylaxis in the hospitals studied was inadequate.

Knowledge about blood donation in patients of a hospital in Amazonas, Peru. / Conocimientos sobre donación de sangre en pacientes de un hospital de Amazonas, Perú.

This study aimed to determine the level of knowledge about blood donation among outpatients from a hospital in Bagua Grande. A descriptive cross-sectional study was conducted from May to July 2019. We developed and applied a structured questionnaire. A total of 244 outpatients were recruited through systematic sampling. Participants obtained a mean number of correct answers of 8.90 (SD: 3.25) points out of 21. Age and educational level were found to be correlated with the score (rho = -0.21; p < 0.001 and rho = 0.38; p < 0.001, respectively). Place of origin and occupation affected the score (p < 0.001). We found a low level of knowledge in the studied population, but this would not be related to previous history of donation. Interventions to improve blood donation should not only focus on providing knowledge, since other factors would be more related to this result.

El objetivo del estudio fue determinar el nivel de conocimientos sobre donación de sangre que tienen los pacientes externos que acuden a un hospital en Bagua Grande. Se realizó un estudio descriptivo transversal durante mayo a julio del 2019. Se elaboró y aplicó un cuestionario estructurado. Se captó a 244 personas que acudieron a consultorios externos mediante un muestreo sistemático. Los participantes obtuvieron una media de respuestas correctas de 8,90 (DE: 3,25) puntos de un total de 21. Se encontró que la edad y el grado de instrucción estaban correlacionados con el puntaje (rho = -0,21; p < 0,001 y rho = 0,38; p < 0,001, respectivamente). La procedencia y ocupación afectaron al puntaje (p < 0,001). Los conocimientos hallados en la población estudiada son bajos, pero esto no estaría relacionado con el antecedente de donación. Las intervenciones que se elaboren para mejorar la donación de sangre no solo se deben enfocar en brindar conocimientos, ya que otros factores estarían más relacionados con este resultado.

Dispositivos médicos en tiempos de pandemia: Eficacia de un sistema artesanal de alto flujo en el manejo de pacientes hospitalizados por COVID-19

Evaluar la eficacia del dispositivo artesanal de asistencia respiratoria no invasivo de administración de presión positiva continua en las vías respiratorias (CPAP) Wayrachi en comparación con la cánula de alto flujo comercial (CAF) para el tratamiento de pacientes con SARS-CoV-2. Estudio realizado en el Hospital Honorio Delgado Espinoza de Arequipa (Hospital COVID-MINSA Arequipa). Se evaluó a las historias clínicas de pacientes con SARS-CoV-2, de severidad moderada o grave que requerían asistencia respiratoria no invasiva, hospitalizados en el servicio de medicina interna durante la segunda ola de COVID en el Perú. Se realizó un análisis de supervivencia considerando los días a la muerte comparando al Wayrachi con la CAF. Se exploró el efecto de las variables sobre la muerte mediante una regresión de Cox. Resultados: Se evaluaron 114 pacientes tratados con Wayrachi (56,44 %) y 88 con CAF (43,5 %), observándose una frecuencia de muerte de 34,2 % y 34,1 % respectivamente. Al comparar la frecuencia de muerte, o su sobrevida, en ambos manejos no se observó una diferencia significativa (p=0,986 y p=0,928), esto se mantuvo en el modelo multivariado. El CPAP Wayrachi tuvo resultados similares a los presentados por el equipo CAF comercial lo que lo indica como una opción eficaz para el manejo de pacientes COVID que requieran soporte respiratorio no invasivo.

To evaluate the efficacy of the Wayrachi continuous positive airway pressure (CPAP) non-invasive respiratory support device compared to the commercial high-flow cannula (CAF) for the treatment of patients with SARS-CoV-2. Study carried out at the Honorio Delgado Espinoza Hospital in Arequipa (Hospital COVID-MINSA Arequipa). The medical records of patients with SARS-CoV-2, of moderate or severe severity, who required non-invasive respiratory assistance, hospitalized in the internal medicine service during the 2nd wave of COVID in Peru, were evaluated. A survival analysis was performed considering days to death comparing Wayrachi with CAF. The effect of variables on death was explored using Cox regression. Results: 114 patients treated with Wayrachi (56.44%) and 88 with CAF (43.5%) were evaluated, observing a frequency of death of 34.2% and 34.1%, respectively. When comparing the frequency of death, or its survival, in both managements, no significant difference was observed (p=0.986 and p=0.928), this was maintained in the multivariate model. The Wayrachi CPAP had similar results to those presented by the commercial CAF equipment, which indicates it as an effective option for the management of COVID patients who require non-invasive respiratory support.

Discusión de la relación entre obesidad y días de hospitalización en pacientes ingresados en UCI-COVID / Discussion on the Relationship between Obesity and Hospitalization Days in Patients Admitted to ICU-COVID

Hemos leído con interés el artículo titulado: Relación de la obesidad con los días de hospitalización en la Unidad de Cuidados Intensivos por la COVID-19, publicado en la Revista Cubana de Medicina.1 Las Unidades de Cuidados Intensivos (UCI) son área altamente complejas, y por esta razón se hace imprescindible una evaluación acerca de la disponibilidad de las camas, para así, planificar el acceso de los pacientes que requieran atención especializada. Al revisar el estudio hemos notado algunos puntos que se deben considerar para una mejor interpretación de los datos. Si bien el estudio plantea una asociación entre dos variables, no se controla dicha asociación por otros factores que podrían afectarla. Los días de estancia en UCI dependen de múltiples factores que pueden aparecer antes y durante la hospitalización, de los cuales no se han medido en el estudio y podrían afectar de forma importante el resultado. Un ejemplo de esto es lo planteado en el artículo con relación a la obesidad y su asociación con diversos antecedentes patológicos, que se mencionan como asociados a la gravedad de la COVID-19. Asimismo, existen otros factores no mencionados en el documento que podrían alterar la asociación como la saturación de oxígeno y la aparición de infecciones...(AU)

Problemas de visión en personas mayores de 50 años en el Perú: Estudio poblacional / Vision problems in people over 50 years old in Peru: A population-based study

RESUMEN Objetivo: Evaluar el antecedente de catarata y problemas de visión en personas mayores de 50 años en el Perú. Métodos: Análisis de base de datos secundaria de la Encuesta Demográfica y de Salud Familiar (ENDES) 2016. Incluimos 7970 adultos mayores de 50 años. Evaluamos los indicadores de interés a nivel nacional y regional. Asimismo, analizamos factores relacionados a estos eventos mediante un modelo multivariado de Poisson. Resultados: Se evidenció un 13,6 % (IC95 %: 12,8-14,3 %) de antecedente de catarata, 20,4 % (IC95 %: 19,5-21,3 %) de problemas de visión de larga distancia (PVLD) y 29,4 % (IC95 %: 28,4-30,4 %) de problemas de visión de corta distancia (PVCD). En el modelo multivariado observamos que las personas con antecedente de hipertensión arterial, antecedente de diabetes y los grupos de edad mayores tenían una probabilidad significativamente mayor de reportar antecedentes de cataratas y problemas de visión. Observamos también que las personas con mejor estado económico presentaron menor frecuencia de PVLD y PVCD. Conclusión: El antecedente de catarata y los problemas de visión en la población estudiada varían de acuerdo a características sociodemográficas y geográficas. La identificación de factores relacionados a estos eventos de interés permite proponer mejores intervenciones para el control de estos problemas.

ABSTRACT Objective: To evaluate the history of cataract and vision problems in people over 50 years of age in Peru. Methods: Secondary database analysis of the Demographic and Family Health Survey (ENDES) 2016. We included 7970 adults over 50 years of age. We evaluated the indicators of interest at the national and regional level. Likewise, we analyzed factors related to these events using a multivariate Poisson model. Results: 13.6% (95% CI: 12.8-14.3%) had a history of cataract, 20.4% (95%CI: 19.5-21.3%) had long-distance vision problems. (LDVP) and 29.4% (95%CI: 28.4-30.4%) of short-distance vision problems (SDVP). In the multivariate model, we observed that people with a history of high blood pressure, a history of diabetes, and older age groups were significantly more likely to report a history of cataracts and vision problems. We also observed that people with a better economic status had a lower frequency of LDVP and SDVP. Conclusion: The history of cataract and vision problems in the studied population vary according to sociodemographic and geographic characteristics. The identification of factors related to these events of interest allows us to propose better interventions to control these problems.

Extended-spectrum ß-lactamase-producing Enterobacteriaceae in cell phones of health care workers from Peruvian pediatric and neonatal intensive care units.

BACKGROUND: Health care workers (HCWs) use their mobile phones during working hours or medical care. There is evidence that the instruments are colonized with pathogenic microorganisms. Here, we describe levels of Enterobacteriaceae contamination (EC) in cell phones and the risk factors associated with EC in Peruvian intensive care units (ICUs). METHODS: This was a 5-month cohort study among 114 HCWs of 3 pediatric and 2 neonatology ICUs from 3 Peruvian hospitals. A baseline survey collected data on risk factors associated with EC. Swabs were collected from HCWs' phones every other week. RESULTS: Three-quarters of HCWs never decontaminated their phones, and 47% reported using the phones in the ICU >5 times while working. EC was frequent across samplings and sites and was substantially higher in subjects with longer follow-up. Potential risk factors identified did not have strong associations with positive samples (relative risk, 0.7-1.5), regardless of significance. Half of the phones were colonized with an Enterobacteriaceae at least once during the 4 samplings attained on average during the study period. Half of the isolates were multidrug resistant (MDR), and 33% were extended-spectrum ß-lactamase producers. CONCLUSIONS: EC on HCWs' phones was frequent and apparently randomly distributed through the hospitals without clear clustering or strongly associated risk factors for having a positive sample. Based on the level of EC, phones may be considered as potential bacterial reservoirs of MDR and ESBL bacteria.

Injuria renal aguda: Características clínicas y epidemiológicas y función renal al alta en un hospital en Perú / Acute kidney injury: Clinical and epidemiological features and kidney function at discharge in a hospital in Peru

Objetivo: Describir las características de la Injuria Renal Aguda (IRA) en pacientes hospitalizados en un hospital de tercer nivel de enero a abril del 2016. Material y métodos: Estudio descriptivo, transversal y retrospectivo que incluyó a los pacientes que ingresaron a los servicios de hospitalización de Medicina y Unidad de Cuidados Intensivos. El diagnóstico de IRA y su clasificación según severidad fueron establecidos según los criterios propuestos por Kidney Disease: Improving Global Outcomes. La función renal al alta fue evaluada mediante la estimación de la tasa de filtración glomerular (TFG). Resultados: La frecuencia general de IRA fue 64,83%. En el servicio de Medicina, la frecuencia fue 57,06% y en UCI, 88,14%. La mortalidad general fue 27,45%. Los pacientes con IRA presentaron anemia, diabetes y enfermedad renal crónica en 84,97%, 20,92% y 19,61%, respectivamente. Según severidad, la frecuencia general fue estadio 3: 46,41%, estadio 1: 30,07% y estadio 2: 23,53%. Las categorías de etiología probable más frecuentes fueron intrínseca (41,83%), pre-renal (27,45%) y multifactorial (15,03%). La mediana de TFG al alta en los pacientes que estuvieron en UCI fue 114,40 ml/min/1,73 m2 y en Medicina, 84,89 ml/min/1,73 m2. Según severidad, la menor mediana de TFG al alta se presentó en los pacientes con estadio 3 y, según etiología probable, aquellos que desarrollaron IRA intrínseca y multifactorial presentaron menor función renal al alta. Conclusiones: IRA es un trastorno frecuente en pacientes hospitalizados. La TFG al alta fue significativamente mayor en los pacientes en UCI que en aquellos en Medicina.

Objetive: To describe the characteristics of Acute Kidney Injury (AKI) in hospitalized patients in a tertiarylevel hospital from January to April of 2016. Material and methods: Retrospective descriptive study that included patients admitted to medical ward and Intensive Care Unit. AKI diagnosis and severity stage were established according to Kidney Disease: Improving Global Outcomes criteria. Kidney function at discharge was evaluated by estimating the glomerular filtration rate (GFR). Results: Overall frequency of AKI was 64.83%. In the medical ward, frequency was 57.06% and in ICU, 88.14%. Overall mortality was 27.45%. The proportion of patients with AKI who had anemia, diabetes and chronic kidney disease was 84.97%, 20.92% and 19.61%, respectively. According to severity stage, the overall frequency was stage 3: 46.41%, stage 1: 30.07% and stage 2: 23.53%. The most frequent categories of probable etiology were intrinsic (41.83%), prerenal (27.45%) and multifactorial (15.03%). The GFR median at discharge in ICU was 114.40 ml/min/1.73 m2, whereas in medical ward, 84.89 ml/min/1.73 m2. According to the severity stage, the lowest GFR median at discharge occurred in patients with stage 3 and, according to probable etiology, those who developed intrinsic and multifactorial AKI had lower kidney function at discharge. Conclusions: AKI is a frequent disorder in hospitalized patients. The GFR at discharge was significantly higher in patients who were in ICU than in medical ward.

Frecuencia de factores ocupacionales asociados a astenopía en trabajadores usuarios de pantallas de visualización de datos de empresas del rubro construcción en Huaraz, 2019 / Frequency of occupational factors associated with astenopia in workers who use data visualization screens of companies in the construction sector in Huaraz, 2019

OBJETIVO: Determinar la frecuencia de factores ocupacionales asociados a astenopía en trabajadores usuarios de pantallas de visualización de datos (PVD) de empresas del rubro construcción de Huaraz, 2019. MATERIAL Y MÉTODOS: Investigación observacional, transversal, de enfoque cuantitativo. Se encuestaron 234 trabajadores usuarios de PVD con 6 a más meses en el puesto laboral actual y más de 4 horas diarias frente a la PVD. El Cuestionario de Síndrome Visual Informático (CVS-Q) permitió identificar astenopía. La prueba Chi cuadrado de independencia, la prueba U Mann Whitney y razón de prevalencias permitieron identificar los factores asociados a astenopía. Se utilizó el paquete estadístico SPSS versión 25. RESULTADOS: La edad promedio fue 35.8 años, el 73.08% fueron varones, el 77.78% utilizaba silla ergonómica, el 60.68% toma descansos breves, el 35.47% y 86.75% trabaja con iluminación y distancia a la PVD adecuada, respectivamente, y el 14.53% presentó astenopía. El puesto laboral administrativo (p < 0.001), la toma de descansos breves (p = 0.023), el nivel inadecuado de iluminación del ambiente laboral (p < 0.001), la distancia inadecuada frente a la PVD (p < 0.001), el extenso tiempo laboral en el área actual (p < 0.001), la elevada cantidad de horas diarias frente a la PVD (p < 0.001), la edad (p < 0.001), el sexo femenino (p = 0.001) y la miopía (p = 0.011) fueron factores asociados a astenopía. CONCLUSIÓN: Los trabajadores administrativos, de sexo femenino, de mayor edad, con mayor tiempo laboral y de horas al día frente a la PVD, que laboran con inadecuada iluminación y distancia frente a la PVD y que tienen miopía presentan mayor probabilidad de padecer astenopía

OBJECTIVE: To determine the freequency of occupational faactors assoociated with asthenopia in users of data display screens (DDS) of companies in the construction sector of Huaraz, 2019. MATERIAL AND METHODS: Observational, cross-sectional, quantitative approach research. 234 DDS user workers were surveyed with 6 or more months in the current job position and more than 4 hours a day in front of the DDS. The Visual Computer Syndrome Questionnaire (CVS-Q) allowed to identify asthenopia. Chi Squaare Test, U Mann Whitney and prevalence ratio allowed us to identify the factors associated with asthenopia. The statistical package SPSS version 25, was used. RESULTS: The average age was 35.8 years, 73.08% were male, 77.78% used ergonomic chair, 60.68% take short breaks, 35.47% and 86.75% worked with adequate lighting and distance to the PVD, respectively, and 14.53% presented asthenopia. The administrative job position (p <0.001), the taking of short breaks (p = 0.023), the inadequate level of illumination of the work environment (p <0.001), the inadequate distance in front of the DDS (p <0.001), the extensive working time in the current area (p <0.001), the high number of daily hours in front of the DDS (p <0.001), age (p <0.001), feemale seex (p = 0.001) and myopia (p = 0.011) weere factors assoociated wiith asthenopia. CONCLUSION: Administrative workers, female, older, with longer working time and hours a day in front of the PVD, who work with inadequate lighting and distance in front of the PVD and have myopia are more likely to suffer asthenopia

[Mental health in physicians doing the rural and suburban health service in Peru: a baseline study]. / Salud mental en médicos que realizan el servicio rural, urbano-marginal en salud en el Perú: Un estudio de línea base.

The disadvantageous conditions in which young physicians have to do their rural and sub-urban health service (SERUMS) may put them in a high risk for mental disorders. This study aims to establish the baseline levels of depression and alcohol use problems among those physicians scheduled to complete their SERUMS during the period 2011-2012. The Center for Epidemiologic Studies Depression Scale (CES-D) and the Alcohol Use Disorders Identification Test (AUDIT) were administered as screening tests to 493 physicians. Depression scores were met by 26% females and 14.5% males, and alcohol use problem scores were met by 22% females and 26% males. Overall, 39% persons scored for either of both mental health entities. Mental health problems seem to be common among young physicians scheduled to migrate to their SERUMS. These problems must be addressed to avoid greater risks.

Deserción universitaria durante el primer año de estudios / No disponible

No disponible