Bovine lactoferrin for the prevention of COVID-19 infection in health care personnel: a double-blinded randomized clinical trial (LF-COVID).

Lactoferrin (LF) has in vitro antiviral activity against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). This study aimed to determine the effect of bovine lactoferrin (bLF) in the prevention of SARS-CoV-2 infection in health care personnel. A randomized, double-blinded, placebo-controlled clinical trial was conducted in two tertiary hospitals that provide care to patients with SARS-CoV-2 infection in Lima, Peru. Daily supplementation with 600 mg of enteral bLF versus placebo for 90 days was compared. Participants were weekly screened for symptoms suggestive of SARS-CoV-2 infection and molecular testing was performed on suspected episodes. A serological test was obtained from all participants at the end of the intervention. The main outcome included symptomatic and asymptomatic cases. A sub-analysis explored the time to symptomatic infection. Secondary outcomes were the severity, frequency, and duration of symptomatic infection. The study was prematurely cancelled due to the availability of vaccines against SARS-CoV-2 in Peru. 209 participants were enrolled and randomized, 104 received bLF and 105 placebo. SARS-CoV-2 infection occurred in 11 (10.6%) participants assigned to bLF and in 9 (8.6%) participants assigned to placebo without significant differences (Incidence Rate Ratio = 1.23, 95%CI 0.51-3.06, p-value = 0.64). There was no significant effect of bLF on time to symptomatic infection (Hazard Ratio = 1.61, 95%CI 0.62-4.19, p-value = 0.3). There were no significant differences in secondary outcomes. A significant effect of bLF in preventing SARS-CoV-2 infection was not proven. Further studies are needed to assess the effect of bLF supplementation on SARS-CoV-2 infection.Clinical trial registration ClinicalTrials.gov Identifier: NCT04526821, https://clinicaltrials.gov/ct2/show/NCT04526821?term=LACTOFERRIN&cond=COVID-19&cntry=PE&city=Lima&draw=2&rank=1 .

Aspirin in Patients With Previous Percutaneous Coronary Intervention Undergoing Noncardiac Surgery.

Background: Uncertainty remains about the effects of aspirin in patients with prior percutaneous coronary intervention (PCI) having noncardiac surgery. Objective: To evaluate benefits and harms of perioperative aspirin in patients with prior PCI. Design: Nonprespecified subgroup analysis of a multicenter factorial trial. Computerized Internet randomization was done between 2010 and 2013. Patients, clinicians, data collectors, and outcome adjudicators were blinded to treatment assignment. (ClinicalTrials.gov: NCT01082874). Setting: 135 centers in 23 countries. Patients: Adults aged 45 years or older who had or were at risk for atherosclerotic disease and were having noncardiac surgery. Exclusions were placement of a bare-metal stent within 6 weeks, placement of a drug-eluting stent within 1 year, or receipt of nonstudy aspirin within 72 hours before surgery. Intervention: Aspirin therapy (overall trial, n = 4998; subgroup, n = 234) or placebo (overall trial, n = 5012; subgroup, n = 236) initiated within 4 hours before surgery and continued throughout the perioperative period. Of the 470 subgroup patients, 99.9% completed follow-up. Measurements: The 30-day primary outcome was death or nonfatal myocardial infarction; bleeding was a secondary outcome. Results: In patients with prior PCI, aspirin reduced the risk for the primary outcome (absolute risk reduction, 5.5% [95% CI, 0.4% to 10.5%]; hazard ratio [HR], 0.50 [CI, 0.26 to 0.95]; P for interaction = 0.036) and for myocardial infarction (absolute risk reduction, 5.9% [CI, 1.0% to 10.8%]; HR, 0.44 [CI, 0.22 to 0.87]; P for interaction = 0.021). The effect on the composite of major and life-threatening bleeding in patients with prior PCI was uncertain (absolute risk increase, 1.3% [CI, -2.6% to 5.2%]). In the overall population, aspirin increased the risk for major bleeding (absolute risk increase, 0.8% [CI, 0.1% to 1.6%]; HR, 1.22 [CI, 1.01 to 1.48]; P for interaction = 0.50). Limitation: Nonprespecified subgroup analysis with small sample. Conclusion: Perioperative aspirin may be more likely to benefit rather than harm patients with prior PCI. Primary Funding Source: Canadian Institutes of Health Research.

[Colon Paracoccidioidomycosis in a hospital from Lima - Peru: report of 4 cases]. / Paracoccidioidomicosis colónica en un hospital de Lima - Perú: reporte de 4 casos.

Paracoccidioidomycosis is the most prevalent mycosis in South America. Mucocutaneous and lymph node involvement is the most frequent affectation of this disease in our country, with the intestinal commitment rarely reported. We report 4 cases of colonic manifestation with abdominal pain, chronic diarrhea, and weight loss. The diagnosis was made with biopsy and Gomori stain. The average age was 29 years old. The colonoscopy showed many ulcers in the ileum distal and colon. We found VIH as comorbidity in one patient.

Conocimientos sobre "su enfermedad" en pacientes con diabetes mellitus tipo 2 que acuden a hospitales generales / Knowledge about "their disease" in patients with type 2 diabetes mellitus treted in general hospitals

Objetivo: Se realizó un estudio cualitativo para medir el nivel de conocimiento, sobre diabetes mellitus 2 en pacientes hospitalizados del Hospital Nacional Arzobispo Loayza y el Hospital Nacional Cayetano Heredia. Material y métodos: Se realizaron entrevistas individuales que fueron grabadas y transcritas; y posteriormente interpretadas y calificadas. Se recogieron de las historias clínicas datos demográficos, complicaciones y tratamiento para contrastarlas con lasrespuestas dadas. Se incluyeron 31 pacientes. Resultados: La edad promedio fue 59,16 años. En 4 pacientes (12,9 %) el nivel de conocimiento sobre la enfermedad fue adecuado, en 15 (48,39 %) intermedio y en 12 (38,71 %) inadecuado. No se hallo asociación estadística entre el nivel de conocimiento con ninguna de las variables estudiadas. Conclusiones: El nivel de conocimientos sobre la diabetes en estos pacientes fue insuficiente. La información obtenida sugiere una educación deficiente de parte de los médicos hacia estos pacientes, lo que hace necesario implementar los programas educativos para ellos.

Objective: To determine knowledge about their disease in patients with type 2 diabetes mellitus treated in generalhospitals. Material and methods: A qualitative study was performed. Individual interviews were conducted with 31 in-hospital patients, under saturation principle. Recorded interviews were transcripted, interpreted and scored by authors. We also obtain demographics, complications and treatment from patients’ medical records data and contrast it with data provided. Results: Mean age was 59.16 years. Mean time since diagnosis was 9.5 years. Four (12.9%) patients had suitable level of knowledge, 15 (48.39%) intermediate level and 12 (38.71%) inadequate level of knowledge about their disease. We found no statistically significant association between level of knowledge and other variables evaluated. Conclusions: We found inadequate level of knowledge about their disease in this patients. Data suggests inadequate patient education from health providers, being necessary to improve educating programs.