[Peruvian Physical Medicine and Rehabilitation residents' perception about their medical residency during the COVID-19 pandemic]. / Percepción de residentes de Medicina Física y Rehabilitación del Perú sobre su residencia médica durante la pandemia por COVID-19.

INTRODUCTION AND OBJECTIVES: The COVID-19 pandemic has affected medical residency (MR) programs worldwide. However, few reports have focused on the MR of Physical Medicine and Rehabilitation (PM&R). Therefore, our objective was to describe the perceptions of PM&R residents in Peru about their MR during the COVID-19 pandemic. MATERIALS AND METHODS: Cross-sectional study. During June 2021, we sought to address all PM&R residents in Peru, using a virtual, anonymous and voluntary survey of 13 questions elaborated in Google Forms, which addressed their perception of RM. RESULTS: Of 142 PM&R residents in Peru, 60 (42.3%) responded to the survey. Among these, 21.7% considered that their residency training site (RTS) met little or nothing with the minimum requirements to be one, 50% that their RTS cared little or notthing for him/her since the start of the COVID-19 pandemic, 35% that the physicians attending their RTS cared little or nothing about academics, and 71.7% that the lack of subspecialist physicians in PM&R greatly affects their training. In addition, 71.7% and 81.7% reported having learned little or nothing about musculoskeletal ultrasound and electrodiagnostic studies, respectively. Finally, 18.3% reported regretting to have chosen the specialty. CONCLUSIONS: We found an important negative perception about MR and a low self-perception of having learned about musculoskeletal ultrasound and electrodiagnostic studies. It is important to delve into the causes and look for alternatives to improve the training of PM&R residents.

The use of unmanned aerial vehicles for health purposes: a systematic review of experimental studies.

BACKGROUND: Unmanned aircraft vehicles (UAVs) have had a rapid escalation in manageability and affordability, which can be exploited in healthcare. We conducted a systematic review examining the use of drones for health-related purposes. METHODS: A search was conducted in Medline, Embase, Global Health, Scopus, CINAHL and SciELO. Experimental studies were selected if the population included human subjects, the intervention was the use of UAVs and there was a health-related outcome. RESULTS: Of 500 results, five met inclusion criteria during an initial search. An updated search yielded four additional studies. Nine studies, all in high-income countries, were included for systematic syntheses: four studies addressed out-of-hospital cardiac arrest emergencies, three assessed drones for identification of people after accidents, one used drones to transport blood samples and one used drones to improve surgical procedures in war zones. CONCLUSIONS: Research on the use of drones in healthcare is limited to simulation scenarios, and this review did not retrieve any studies from low- and middle-income countries.

Guía de práctica clínica para la evaluación y el manejo de la hemorragia digestiva alta en el Seguro Social del Perú (EsSalud) / Clinical practice guideline for the evaluation and management of upper gastrointestinal bleeding for the Peruvian Social Security (EsSalud)

Objetivo: Proveer recomendaciones clínicas basadas en evidencia para la evaluación y el manejo de pacientes con hemorragia digestiva alta (HDA) en el seguro social del Perú (EsSalud). Materiales y métodos: Se conformó un grupo elaborador local (GEG-Local) conformado por especialistas en gastroenterología y metodólogos. El GEG-Local formuló 11 preguntas clínicas a ser respondidas por la presente guía de práctica clínica (GPC). Se buscaron y seleccionaron GPC de HDA publicadas a partir del 2012, que respondieran a las preguntas planteadas y obtuvieran un puntaje mayor a 60% en los dominios 1 y 3 del instrumento Appraisal of Guidelines for Research and Evaluation II (AGREE-II). Durante septiembre del 2017 se realizaron búsquedas bibliográficas en Pubmed, para actualizar 9 preguntas clínicas de las GPC preseleccionadas, y para responder 2 preguntas de novo. La calidad de la evidencia fue evaluada usando la metodología Grading of Recommendations Assessment, Development, and Evaluation (GRADE). En reuniones de trabajo periódicas, el GEG-Local revisó la evidencia y formuló las recomendaciones, los puntos de buenas prácticas clínicas y el flujograma de evaluación y manejo, usando la metodología GRADE Finalmente, la GPC fue aprobada con Resolución N° 80-IETSI-ESSALUD-2017. Resultados: La presente GPC abordó 11 preguntas clínicas, divididas en cuatro temas: valoración de riesgo, manejo inicial, manejo de HDA no variceal, y manejo de HDA variceal. En base a dichas preguntas se formularon 10 recomendaciones (7 recomendaciones fuertes y 3 recomendaciones débiles), 24 puntos de buena práctica clínica, y 2 flujogramas. Conclusión: Este artículo es el resumen de la GPC de EsSalud, en la cual se valoró la evidencia científica disponible sobre evaluación y manejo de HDA.

Objective: To provide evidence-based clinical recommendations for the evaluation and management of patients with upper gastrointestinal bleeding (UGB) in the Peruvian Social Security (EsSalud). Materials and methods: A local guideline development group (local GDG) was established, including specialists in gastroenterology and methodologists. The local GDG formulated 11 clinical questions to be answered by this clinical practice guide (CPG). We searched and selected CPG of UGB published from 2012, which answered the posed questions and obtained a score higher than 60% in domains 1 and 3 of the Appraisal of Guidelines for Research and Evaluation II (AGREE-II) tool. During September 2017, bibliographic searches were conducted in Pubmed, to update 9 clinical questions of the preselected CPGs, and to answer 2 de novo questions. The quality of the evidence was evaluated using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology. In periodic work meetings, the local GDG reviewed the evidence and formulated the recommendations, points of good clinical practice and the flowchart of evaluation and management, using the GRADE methodology Lastly, the CPG was approved with Resolución N° 80-IETSI-ESSALUD-2017. Results: This CPG addressed 11 clinical questions, divided into four themes: risk assessment, initial management, management of non-variceal UGB, and management of variceal UGB. Based on these questions, 10 recommendations (7 strong recommendations and 3 weak recommendations), 24 points of good clinical practice, and 2 flow charts were formulated. Conclusion: This article is the summary of the EsSalud' CPG, where the available scientific evidence on evaluation and management of UGB was evaluated.

Factors associated with regular sunscreen use by medical students of a Peruvian university.

INTRODUCTION: Use of sunscreen is encouraged to reduce the risk of skin pathologies caused by radiation. It is important to acknowledge the associated factors that promote or hinder sunscreen use in young populations as to design better prevention policies. OBJECTIVE: To determine the factors associated with regular sunscreen use among first year medical students from a Peruvian university. MATERIALS AND METHODS: A cross-sectional study was performed. Our population was first-year medical students from a Peruvian university. We administrated an electronic survey to evaluate socio-demographic data, as well as student knowledge, attitudes, and practices regarding photo-protection. We used ordinal logistic regression to analyze the factors associated with sunscreen use. RESULTS: Of 420 first-year students, 299 completed our survey. We found that 53.5% of the participants were less than 18 years old, 63.2% were female, 9.3% (females more than males) responded that a sunburn was worth it to look tan, and 38.1% always or almost always used sunscreen during the summer. Factors associated with sunscreen use in the ordered logistic adjusted regression were male sex (OR = 0.50, IC95% = 0.34-0.86), participation in photo-protection workshops within the last year (OR = 2.40, IC95% = 1.28-4.37), and having somebody to remind them the use of sunscreen during the last three months (OR = 3.80, IC95% = 1.28-11.20). CONCLUSIONS: In our sample, a higher sunscreen use was more often observed among female participants, those who attended skin protection workshops, and those reminded to use sunscreen. This highlights the importance of educational and reminder activities in the adoption of protective habits, such as sunscreen use.

Evidence of a direct projection of the vomeronasal organ to the medial preoptic nucleus and hypothalamus.

In rodents the vomeronasal system plays an important role in modulating the hypothalamic control of gonadotropin secretion. It is accepted that the anatomical pathways by which the vomeronasal organ influences the neuroendocrine aspects of the reproductive behavior involves a polysynaptic system, including the accessory olfactory bulb, the 'vomeronasal amygdala', the bed nucleus of the stria terminalis and medial preoptic and ventromedial hypothalamic nuclei. We found that 72 h after unilateral transection of the vomeronasal nerves of an ipsilateral orthograde degeneration is seen in the neuropil of the medial preoptic, ventromedial, and arcuate hypothalamic nuclei. This represents an anatomical evidence of a monosynaptic link between the vomeronasal neuroepithelium and the medial preoptic nucleus, and hypothalamus.