[Severe asthma: Pathophysiology, diagnosis, and treatment]. / Asma grave: fisiopatología, diagnóstico y tratamiento.

Severe asthma is an entity with a complex diagnosis, requiring an adequate differential diagnosis and identification of endotypes for a correct approach and therapeutic process. In the present review, we show a synthesis of the current literature on the diagnosis, pathophysiology, and management of severe asthma, having critically analyzed the evidence in search engines such as Medline, Scopus, and Embase.

El asma grave es una enfermedad compleja, que requiere un enfoque y diagnóstico diferencial ordenado e identificación de endotipos para el correcto abordaje y tratamiento. El tratamiento farmacológico cuenta cada vez con más moléculas a disposición del personal médico para el control efectivo de los síntomas. Esta revisión muestra una síntesis de la bibliografía actual acerca del diagnóstico, fisiopatología y tratamiento del asma grave, mediante la lectura crítica previa de la evidencia científica en buscadores como Medline, Scopus y Embase.

Association between Subclinical Hypothyroidism and Glycemic Control in Older Adults in a Medical Center in Peru.

Objective: To determine whether there is an association between subclinical hypothyroidism and glycemic control in older adults who received care at the "Centro Médico Naval" from 2010 to 2015. Methods: This retrospective analytical study analyzed a secondary database of the care of elderly in the study hospital. The sample was comprised of 1,385 older adults. To detect an association between variables, the Poisson regression with robust variance was used at a significance level of 95%. The analyses were carried out with the STATA 16 program. Results: Of the elderly 45.6% were between 71 and 80 years old; 58.4% were women and 43.8% had a normal body mass index. There was evidence of inadequate glycemic control in 8.1% and subclinical hypothyroidism in 15.2% of the elderly patients. Subclinical hypothyroidism was more frequent in the inadequate glycemic control vs. adequate glycemic control populations (41.1% vs. 13.0%). In the multivariance analysis, subclinical hypothyroidism (aPR = 2.22 95% CI [1.47-3.36]) was independent factor associated with inadequate glycemic control (p < 0.001). Conclusions: A significant association was detected between subclinical hypothyroidism and inadequate glycemic control in older adults who presented at the "Centro Médico Naval" from 2010 to 2015.

Association between gait speed and balance disorders in older adults from 12 high Andean Peruvian communities, 2013-2019.

Background: Gait speed is associated with a higher prevalence of balance disorders in older adults residing at high altitudes. This study investigated this association in older adults from 12 high-altitude Andean Peruvian communities. Methods: We performed a secondary data analysis from an analytical cross-sectional study of adults >60 years of age, residing in 12 high-altitude Andean Peruvian communities, enrolled between 2013 and 2019. The exposure and outcome variables were gait speed (categorized in tertiles), and balance disorders (defined as a functional reach value of ≤20.32 cm), respectively. We built generalized linear models of the Poisson family with a logarithmic link function and robust variances, and estimated crude prevalence ratios (cPR) and adjusted prevalence ratios (aPR) with 95% confidence intervals (CIs). Results: We analyzed 418 older adults; 38.8% (n=162) were male, and the mean age was 73.2 ± 6.9 years. The mean gait speed and functional reach were 0.66 ± 0.24 m/s and 19.9 ± 6.48 cm, respectively. In the adjusted regression model, the intermediate (aPR=1.88; 95% CI: 1.39-2.55; p<0.001) and low (aPR=2.04; 95% CI: 1.51-2.76; p<0.001) tertiles of gait speed were associated with a higher prevalence of balance disorders. Conclusions: The intermediate and low tertiles of gait speed were associated with a higher prevalence of balance disorders among older adult residents of 12 high-altitude Andean communities. We recommend further research on the behavior of this association to propose interventions for these vulnerable groups and reduce the impact of geriatric conditions.

Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study.

INTRODUCTION: Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. We aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥55 years in Lima, Peru. METHODS: This cross-sectional study was conducted between 2018 and 2020. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS2) guidelines. We measured muscle strength by maximum handgrip strength and muscle mass using bioelectrical impedance analyzer. SO was defined as a body mass index ≥ 30 kg/m2 and sarcopenia. RESULTS: The study participants had a mean age of 66.2 years (SD 7.1), age range between 60 to 92 years old, of which 621 (53.9%) were men. Among the sample, 41.7% were classified as obese (BMI ≥30.0 kg/m²). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3-25.1) using the EWGSOP2 criteria and 27.8% (95%CI: 25.2-30.4) using the AWGS2 criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4-7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7-9.9) using AWGS2 criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8-20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3-1.3) to 5.0% (95%CI: 3.8-6.3). CONCLUSION: Our findings reveal substantial variation in the prevalence of sarcopenia and SO, underscoring the necessity for context-specific cut-off values. Although the prevalence of SO was relatively low, this result may be underestimated. Furthermore, the consistently high proportion of probable sarcopenia and sarcopenia point to a substantial public health burden.

Correlation between Instrumental Activities of Daily Living and muscle mass in older adults: impact of comorbidities.

Background: There is evidence that sarcopenia and functionality are closely related. However, the association between geriatric syndromes, such as dependence, on instrumental activities and sarcopenia could be affected by the presence of certain comorbidities, such as overweight, obesity, diabetes, and chronic obstructive pulmonary disease (COPD). Therefore, the present study aimed to determine the association between instrumental activities of daily living and muscle mass in the elderly and evaluate the impact of certain comorbidities on this association. Methods: This was a retrospective analytical observational study, including 1897 patients. Muscle mass was measured with calf circumference, and instrumental activities were measured with the Lawton index. Results: Among different parameters studies, a statistical correlation was found in a stratified regression analysis between the Lawton index score and muscle mass in patients who were overweight (p value:0.001 ;beta coefficient: 0.08), obese (p value: 0.001 ; beta coefficient: 0.05), had diabetes (p value: 0.012 ;beta coefficient: 0.03), and had COPD (p value:0.001 ;beta coefficient:0.03). Conclusion: The correlation between muscle mass and instrumental activities of daily living should be evaluated individually according to the needs of each participant and according to their comorbidities, promoting patient-centered geriatric medicine.

Evaluation of Factors Influencing Handgrip Strength Asymmetry in Older Peruvian Adults.

BACKGROUND: Sarcopenia is a musculoskeletal disease involving the reduction of muscle mass, strength, and performance. Handgrip strength (HGS) measurements included in frailty assessments are great biomarkers of aging and are related to functional deficits. We assessed the association between potential influencing factors and HGS asymmetry in older Peruvian adults. METHODS: We used a database of the Peruvian Naval Medical Center "Cirujano Santiago Távara" located in Callao, Peru. All the patients included were ≥60 years old and had an HGS measurement in the dominant and non-dominant hand. RESULTS: From a total of 1,468 patients, 74.66% had HGS asymmetry. After adjustment, calf circumference weakness (adjusted prevalence ratio [aPR]=1.08; 95% confidence interval [CI], 1.01-1.15), falls risk (aPR = 1.08; 95% CI, 1.02-1.16), and an altered Lawton index (aPR=0.92; 95% CI, 0.84-0.99) were associated with HGS asymmetry. CONCLUSION: Our findings suggest that HGS asymmetry should be measured along with other geriatric assessments used to evaluate health outcomes in the elderly to enhance health promotion and prevention aimed at preserving muscle strength to curb functional limitations in the elderly.

Acute abdomen following COVID-19 vaccination: a systematic review.

Purpose: Conduct a systematic review of case reports and case series regarding the development of acute abdomen following coronavirus disease 2019 (COVID-19) vaccination, to describe the possible association and the clinical and demographic characteristics in detail. Materials and Methods: This study included case report studies and case series that focused on the development of acute abdomen following COVID-19 vaccination. Systematic review studies, literature, letters to the editor, brief comments, and so forth were excluded. PubMed, Scopus, EMBASE, and Web of Science databases were searched until June 15, 2023. The Joanna Briggs Institute tool was used to assess the risk of bias and the quality of the study. Descriptive data were presented as frequency, median, mean, and standard deviation. Results: Seventeen clinical case studies were identified, evaluating 17 patients with acute abdomen associated with COVID-19 vaccination, which included acute appendicitis (n=3), acute pancreatitis (n=9), diverticulitis (n=1), cholecystitis (n=2), and colitis (n=2). The COVID-19 vaccine most commonly linked to acute abdomen was Pfizer-BioNTech (messenger RNA), accounting for 64.71% of cases. Acute abdomen predominantly occurred after the first vaccine dose (52.94%). All patients responded objectively to medical (88.34%) and surgical (11.76%) treatment and were discharged within a few weeks. No cases of death were reported. Conclusion: Acute abdomen is a rare complication of great interest in the medical and surgical practice of COVID-19 vaccination. Our study is based on a small sample of patients; therefore, it is recommended to conduct future observational studies to fully elucidate the underlying mechanisms of this association.

Asociación entre el nivel de conocimiento sobre COVID-19 y actitudes ante la vacunación en estudiantes de Ciencias de la Salud

Introducción: En el Perú la COVID-19 es un tema de interés para la salud pública ya que impacta negativamente a nivel social, económico y psicológico. Según la OMS reportó 769 369 823 casos confirmados de COVID-19 y hasta Agosto del 2023 se han inoculado un total de 13 492 225 267 dosis de vacunas. Objetivo: Determinar si existe asociación entre el conocimiento sobre COVID-19 y la actitud ante la vacunación en los estudiantes de la "Facultad de Ciencias de la Salud" de la "Universidad Científica del Sur" Lima-Perú. Metodología: Se realizó un estudio observacional - analítico- transversal, que buscó analizar el conocimiento sobre COVID-19, utilizando un cuestionario diseñado por investigadores Ortega Paredes y col. y actitudes ante la vacunación utilizando la escala de la revista por Abdul Mannan y col. Los datos fueron analizados en el programa OpenEpi versión 3. Resultados: Fueron encuestado 576 estudiantes de ciencias de la salud, el 20,49 % fueron del sexo masculino, el promedio de edad fue 21,3 con una desviación estándar de 5,93 años. En relación con la variable conocimiento sobre COVID-19, solo 4,17 % tuvieron conocimientos escasos. Se evaluó mediante una escala con 15 preguntas con un puntaje máximo de 24. En promedio, el puntaje de actitud ante la vacunación fue de 3,80 con una desviación estándar de 1,66. Se evaluó mediante una escala de 9 preguntas, el puntaje de la escala osciló entre 0 lo cual significa una actitud totalmente negativa y 9 significa una actitud totalmente positiva. Discusión: En conclusión en un modelo ajustado por variables sociodemográficas y conocimientos sobre terapias no probadas sobre COVID-19 encontramos que un conocimiento adecuado sobre la enfermedad, se asocia con promedios más altos del puntaje de actitudes ante la vacunación por lo cual consideramos importante impartir adecuados conocimientos sobre el COVID-19 para fomentar mejores actitudes ante la vacunación de esta enfermedad, que continuará siendo una infección respiratoria en la cual los médicos debemos tomar en cuenta.

Introduction: In Peru, COVID-19 is a topic of interest for public health since it negatively impacts at a social, economic and psychological level. According to the WHO, 769 369 823 confirmed cases of COVID-19 have been reported and up to August 2023 there have been inoculated a total of 13.492.225.267 doses of vaccines. Objective: To determine if there is an association between knowledge about COVID-19 and the attitude towards vaccination in students of the "Faculty of Health Sciences" of the "Universidad Científica del Sur", Lima-Perú. Methods: An observational-analytical-cross-sectional study was carried out, which sought to analyze knowledge about COVID-19, using a questionnaire designed by the researchers Ortega Paredes et al. and attitudes towards vaccination using the magazine scale by Abdul Mannan et al. The data was analyzed in the OpenEpi version 3 program. Results: 576 health sciences students were surveyed, 20,49% were male, the average age was 21,3 with a standard deviation of 5,93 years. In relation to the knowledge variable about COVID-19, only 4,17% had little knowledge. It was evaluated using a scale with 15 questions with a maximum score of 24. On average, the attitude score towards vaccination was 3,80 with a standard deviation of 1,66. It was evaluated using a nine-question scale, the scale score ranged from 0, which means a totally negative attitude, and nine, meaning a totally positive attitude. Discussion: In conclusion, in a model adjusted for sociodemographic variables and knowledge about unproven therapies on COVID-19, we found that adequate knowledge about the disease is associated with higher average scores for attitudes towards vaccination, for which we consider it important to impart adequate knowledge about COVID-19 to promote better attitudes towards vaccination against this disease, which will continue to be a respiratory infection in which doctors must take into account.

Sarcopenia and sarcopenic obesity among community-dwelling Peruvian adults: A cross-sectional study.

Background: Sarcopenia and sarcopenic obesity (SO) have emerged as significant contributors to negative health outcomes in the past decade. However, there remains a lack of consensus on the criteria and cut-off thresholds for assessing sarcopenia and SO. Moreover, limited data are available on the prevalence of these conditions in Latin American countries. To address this evidence gap, we aimed to estimate the prevalence of probable sarcopenia, sarcopenia, and SO in a community-dwelling population of 1151 adults aged ≥ 55 years in Lima, Peru. Methods: Data collection for this cross-sectional study was conducted between 2018 and 2020 in two urban low-resource settings in Lima, Peru. Sarcopenia was defined as the presence of low muscle strength (LMS) and low muscle mass (LMM) according to European (EWGSOP2), US (FNIH) and Asian (AWGS) guidelines. We measured muscle strength by maximum handgrip strength; muscle mass using a whole-body single-frequency bioelectrical impedance analyzer, and physical performance using the Short Physical Performance Battery and 4-meter gait speed. SO was defined as a body mass index ≥ 30 kg/m2 and sarcopenia. Results: The study participants had a mean age of 66.2 years (SD 7.1), of which 621 (53.9%) were men, and 41.7% were classified as obese (BMI ≥ 30.0 kg/m2). The prevalence of probable sarcopenia was estimated to be 22.7% (95%CI: 20.3-25.1) using the EWGSOP2 criteria and 27.8% (95%CI:25.2-30.4) using the AWGS criteria. Sarcopenia prevalence, assessed using skeletal muscle index (SMI), was 5.7% (95%CI: 4.4-7.1) according to EWGSOP2 and 8.3% (95%CI: 6.7-9.9) using AWGS criteria. The prevalence of sarcopenia based on the FNIH criteria was 18.1% (95%CI: 15.8-20.3). The prevalence of SO, considering different sarcopenia definitions, ranged from 0.8% (95%CI: 0.3-1.3) to 5.0% (95%CI: 3.8-6.3). Conclusions: Our findings reveal substantial variation in the prevalence of sarcopenia and SO when using different guidelines, underscoring the necessity for context-specific cut-off values. Nevertheless, regardless of the chosen guideline, the prevalence of probable sarcopenia and sarcopenia among community-dwelling older adults in Peru remains noteworthy.

Discontinuation of Antihypertensive Drug Use Compared to Continuation in COVID-19 Patients: A Systematic Review with Meta-analysis and Trial Sequential Analysis.

INTRODUCTION: COVID-19 related mortality is about 2%, and it increases with comorbidities, like hypertension. Regarding management, there is debatable evidence about the benefits of continuation vs. discontinuation of angiotensin-converting enzyme inhibitors and angiotensin receptor blockers (ACEI/ARB). AIM: We performed a systematic review to assess the effects and safety of in-hospital discontinuation compared to continuation of ACEI/ARB in COVID-19 patients. METHODS: We systematically searched on PubMed, Scopus, and EMBASE from inception to June 19, 2021. We included observational studies and trials that compared the effects and safety of continuing ACEI/ARB compared to discontinuing it in COVID-19 patients. Effects sizes for dichotomous variables were expressed as risk ratios (RR) and 95% confidence intervals. For continuous variables, effects were expressed as mean difference (MD). We used random effect models with the inverse variance method. We assessed certainty of evidence using the GRADE approach. RESULTS: We included three open-label randomized controlled trials and five cohort studies. We found that the continuation group had lower risk of death compared with the discontinuation group only in the cohort group (RR: 0.46, 95% CI: 0.24-0.90), but not in the RCT group (RR: 1.22, 95% CI: 0.75-2.00). The ICU admission rate was significantly lower in the continuation group (RR: 0.46, 95% CI: 0.31-0.68) in the cohort group, but not in RCT group (RR: 1.03, 95% CI: 0.67-1.59). We did not find significant differences between groups regarding hospitalization length, hypotension, AKI needing renal replacement therapy, mechanical ventilation, new or worsening heart failure, myocarditis, renal replacement therapy, arrhythmias, thromboembolic events and SOFA AUC. The GRADE approach revealed that the certainty ranged from moderate to high level. CONCLUSIONS: There is no significant difference in mortality and other outcomes between continuation and discontinuation groups.

Factors associated with mortality in patients hospitalized for COVID-19 admitted to a tertiary hospital in Lambayeque, Peru, during the first wave of the pandemic.

INTRODUCTION: COVID-19 caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has spread worldwide, becoming a long-term pandemic. OBJECTIVES: To analyze the factors associated with mortality in patients hospitalized for COVID-19 in a tertiary hospital in the Lambayeque region of Peru. METHODS: A retrospective cohort study of patients with a diagnosis of COVID-19, hospitalized in a hospital in northern Peru, was conducted from March to September 2020. RESULTS: Of the 297 patients studied, 69% were women, the mean age was 63.99 years (SD = ±15.33 years). Hypertension was the most frequent comorbidity (36.67%), followed by diabetes mellitus (24.67%) and obesity (8.33%). The probability of survival at 3 days of ICU stay was 65.3%, at 7 days 24.2%, and 0% on day 14. Risk factors associated with mortality in patients hospitalized for COVID-19 are age, male sex, tachypnea, low systolic blood pressure, low peripheral oxygen saturation, impaired renal function, elevated IL-6 and elevated D-dimer. CONCLUSIONS: Mortality in hospitalized patients with COVID-19 was 51.18 per 100 persons, Mortality was found to be associated with hypertension, type of infiltrating, and sepsis.

Asociación entre el bajo nivel de vitamina B12 y deterioro cognitivo en adultos mayores del centro médico naval del Perú

Introducción: Los adultos mayores son suscepctibles a la malnutrición y el déficit de vitaminas. Objetivo: Determinar la asociación entre el bajo nivel de vitamina B12 y el deterioro cognitivo en adultos mayores del centro médico naval, ubicado en Lima-Perú, en el periodo 2010-2015. Métodos : Se realizó un estudio transversal analítico, a partir de un análisis secundario de la base de datos Texas-Cemena UTMB 2010-2015 del centro de investigación del envejecimiento (CIEN) de la Universidad De San Martín De Porres. Para la cuantificación de la variable de deterioro cognitivo se utilizó el MiniMental test. Para analizar la asociación, se realizó la prueba de chi cuadrado y la regresión de Poisson. Resultados : El 57,6% de los pacientes fueron de sexo masculino y la edad promedio fue de 78 ± 8,4. El 41,2% presentó deterioro cognitivo y el 9,5% de los pacientes presentó déficit de vitamina b12. Los factores independientemente asociados al deterioro cognitivo fueron el antecedente de enfermedad cerebro vascular (RP= 1,38 IC 95% [1,24-1,53]), depresión (RP = 1,88 IC 95% [1,80-1,97]),) y déficit de vitamina B12 (RP = 1,10 ic 95% [1,01-1,20]),). Conclusiones : En el presente estudio se encontró asociación entre un bajo nivel de vitamina B12 y el deterioro cognitivo en adultos mayores.

Introduction: Older adults are susceptible to malnutrition and vitamin deficiency. Objective: To determine the association between the low level of vitamin B12 and cognitive deterioration in older adults from the Naval Medical Center, located in Lima-Peru, in the period 2010-2015. Methods: An analytical cross-sectional study was carried out, based on a secondary analysis of the Texas-Cemena UTMB 2010-2015 database of the center for research on aging (cien) of The University Of San Martín De Porres. To quantify the cognitive impairment variable, the mini mental test was used. To analyze the association, the chi-square test and poisson regression were performed. Results: 57.6% of the patients were male and the mean age was 78 ± 8.4. 41.2% presented cognitive deterioration and 9.5% of the patients presented vitamin B12 deficiency. The factors independently associated with cognitive impairment were a history of cerebrovascular disease (pr= 1.38 95% ci [1.24-1.53]), depression (pr= 1.88 95% ci [1.80-1 .97]) and vitamin B12 deficiency (pr = 1.10 95% ci [1.01-1.20]). Conclusions: In the present study, an association was found between a low level of vitamin B12 and cognitive deterioration in older adults.

Factores asociados a la calidad de vida en adultos mayores con insuficiencia orgánica crónica avanzada en un hospital de Lima-Perú

Objetivo: Determinar los factores asociados a la calidad de vida en adultos mayores con insuficiencia orgánica crónica avanzada en un hospital de Lima-Perú. Materiales y métodos: Investigación observacional, analítica transversal, cuya población la conformaron 100 adultos mayores, la técnica de recolección fue la entrevista y el instrumento el cuestionario a través de la aplicación del índice de Barthel y WHOQoL-Bref. Para responder a los objetivos de estudio se aplicaron las pruebas no paramétricas u de Mann Whitney, Kruskal Wallis y Rho de Spearman, considerando la significancia del 5%. Resultados: El (44) 44% de adultos mayores tuvieron más de 80 años, el (59) 59% fueron varones, el (31) 31% estudiaron nivel técnico superior, el (57) 57% fueron titulares en la marina de guerra, el (74) 74% tuvo hipertensión arterial. Los síndromes geriátricos más frecuentes fueron déficit visual o auditivo (82) 82%, insomnio (59) 59%, estreñimiento (52) 52% y malnutrición (47) 47%. El (50) 50% de los adultos mayores presentó dependencia funcional grave. El (63)63% presentó calidad de vida a nivel medio. Los factores epidemiológicos asociados a la baja calidad de vida, fueron la edad mayor a 80 años (p=0,032, RP=1,818), sexo femenino (p=0,009, RP=2,056), el grado de instrucción dado por analfabeto, primaria y secundaria (p=0,025, RP=1,930) y la relación con la marina de guerra como familiar (p=0,022, RP=1,894). Los síndromes geriátricos asociados fueron el insomnio (p=0,034, RP=1,930), el estreñimiento (p=0,000, RP=3,560), la lesión por presión (p=0,000, RP=2,788) y la dependencia funcional grave (p=0,000, RP=4,667). Sin embargo, el análisis multivariado evidenció que el insomnio (p=0,002; RPa=1,166), la lesión por presión (p=0,016; RPa=1,248) y la dependencia grave (p=0,000; RPa=1,207) fueron los factores asociados significativamente a la baja calidad de vida en los adultos mayores. Conclusiones: Los factores insomnio, la lesión por presión y la dependencia grave estuvieron asociados significativamente a la calidad de vida baja en los adultos mayores con insuficiencia orgánica crónica avanzada en un hospital de lima-Perú.

Objective: To determine the factors associated with the quality of life in older adults with advanced chronic organ failure in a hospital in Lima-Peru. Materials and methods: Observational research, cross-sectional analysis, whose population was made up of 100 older adults, the collection technique was the interview and the instrument the questionnaire through the application of the Barthel index and WHOQoL-Bref. To respond to the study objectives, the non-parametric Mann Whitney u, Kruskal Wallis and Spearman's Rho tests were applied, considering the significance of 5%. Results: (44) 44% of older adults were over 80 years old, (59) 59% were men, (31) 31% studied a higher technical level, (57) 57% were incumbents in the navy, (74) 74% had arterial hypertension. The most frequent geriatric syndromes were visual or auditory deficit (82) 82%, insomnia (59) 59%, constipation (52) 52% and malnutrition (47) 47%. The (50) 50% of the older adults presented severe functional dependence. (63) 63% presented quality of life at a medium level. The epidemiological factors associated with low quality of life were age over 80 years (p=0.032, RP=1.818), female sex (p=0.009, RP=2.056), the level of education given by illiterate, primary and secondary school (p=0.025, RP=1.930) and the relationship with the navy as a family member (p=0.022, RP=1.894). Associated geriatric syndromes were insomnia (p=0.034, RP=1.930), constipation (p=0.000, RP=3.560), pressure injury (p=0.000, RP=2.788) and severe functional dependence (p= 0.000, PR=4.667). However, the multivariate analysis showed that insomnia (p=0.002; RPa=1.166), pressure injury (p=0.016; RPa=1.248) and severe dependence (p=0.000; RPa=1.207) were the associated factors. Significantly to the low quality of life in older adults. Conclusions: The factors insomnia, pressure injury and severe dependency were significantly associated with low quality of life in older adults with advanced chronic organ failure in a hospital in Lima-Peru.

Correlación entre el porcentaje de grasa corporal y el índice de masa corporal en adultos mayores: rol del sexo y edad / Correlation between body fat percentage and body mass index in the elderly: role of sex and age

Fundamentos: Dado el aumento de la población mayor, que está predispuesta a padecer enfermedades relacionadas con la obesidad, es necesario disponer de herramientas precisas para medirla. El objetivo de este estudio fue determinar la correlación entre el porcentaje de grasa corporal (%GC) y el índice de masa corporal (IMC) en los adultos mayores, ajustando dicha correlación por edad y sexo. Métodos: Se trata de un estudio retrospectivo, transversal y analítico conformado por datos de 50 adultos mayores atendidos en el "Servicio de Geriatría del Hospital Central de la Fuerza Aérea del Perú" durante los años 2019-2020. El porcentaje de grasa corporal se determinó mediante dos métodos: absorciometría dual de rayos X (DXA) e impedancia bioeléctrica (BIA). Resultados: Utilizando el análisis de regresión logística, se observó que las variables significativas asociadas al IMC eran el %GC, determinado por BIA, tanto en hombres como en mujeres, y determinado por DXA, el %GC en mujeres. Conclusiones: Por lo general, los resultados mostraron una correlación positiva entre el IMC y el %GC, independientemente del dispositivo utilizado. Dicha relación fue mayor en el sexo femenino. La edad tuvo un efecto menos significativo. (AU)

Background: Due to the growing elderly population, more of whom have a predisposition to obesity-related diseases, there is a need for precise tools that measure obesity. The objective of this study was to determine the correlation between body mass index (BMI) and body fat percentage (BF%) in the elderly. Additionally, the correlation would be observed adjusting for age and gender. Methods: This was a retrospective, cross-sectional, analytical study comprised of 50 individuals aged ≥60 attended in the "Geriatric Care of the Central Hospital of the Air Force of Peru" during the years 2019-2020. Body fat percentage was determined by two methods: dual-energy x-ray absorptiometry (DXA) and bioelectrical impedance (BIA). Results: Using logistic regression analysis, the significant variables associated with BMI were BF%, determined by BIA, in both men and women, as well as BF%, determined by DXA in women. Conclusions: Generally, the results showed a positive correlation between BMI and BF%, regardless of the apparatus utilized. The relationship was strongest in females. Age was reported to have a less significanteffect. (AU)

Self-Medication Practices, Use of Brand-Name, and Over-the-Counter Medicines by Peruvian Older Adults.

Background: Older adults are a particularly vulnerable group to drug use and self-medication. The aim of the study was to evaluate self-medication as a factor associated with the purchase of brand-name and over-the-counter (OTC) drugs in older adults in Peru. Methods: A secondary analysis was performed using an analytical cross-sectional design of data from a nationally representative survey from 2014 to 2016. The exposure variable was self-medication, defined as the purchase of medicines without a prescription. The dependent variables were purchases of brand-name and OTC drugs, both as a dichotomous response (yes/no). Information of sociodemographic variables, health insurance, and the types of drugs purchased by the participants was collected. Crude prevalence ratios (PR) were calculated and adjusted using generalized linear models of the Poisson family, considering the complex sample of the survey. Results: In this study, 1,115 respondents were evaluated, with a mean age of 63.8 years and a male proportion of 48.2%. The prevalence of self-medication was 66.6%, while the proportions of purchases of brand-name and OTC drugs were 62.4% and 23.6%, respectively. The adjusted Poisson regression analysis revealed an association between self-medication and the purchase of brand-name drugs (adjusted PR [aPR]=1.09; 95% confidence interval [CI]: 1.01-1.19). Likewise, self-medication was associated with the purchase of OTC medications (aPR=1.97; 95%CI: 1.55-2.51). Conclusions: This study evidenced a high prevalence of self-medication in Peruvian older adults. Two-thirds of the surveyed people bought brand-name drugs, whereas one-quarter bought OTC drugs. Self-medication was associated with a greater likelihood of buying brand-name and OTC drugs.

[Frequency of food allergy in students of human medicine of a private university]. / Frecuencia de alergia alimentaria en estudiantes de medicina humana de una universidad privada.

OBJECTIVE: Determine the frequency of total food allergy, and to Peruvian products, in Human Medicine students. METHODS: A study design is observational, descriptive and retrospective was made. Human medicine students, aged 18-25 from a private Peruvian university were included in a type of snowball sampling via electronic messaging. The sample size was calculated using the OpenEpi v3.0 program and the prevalence formula. RESULTS: We registered 355 students, with a mean age of 20.87 years (SD ± 5.01). A frequency of food allergy was also found in 9.3% of the total participants in terms of native products and common in other countries, the highest percentage are seafood 2.24%, spices and condiments 2.24%, allergy to fruits 1.4%, milk 1.4%, red meat 0.84%. CONCLUSIONS: The frequencies of self-reported food allergy produced was 9.3% by native Peruvian products and commonly consumed nationwide.

OBJECTIVO: Determinar la frecuencia de alergia alimentaria en general, y de productos de consumo común oriundos del Perú, en estudiantes de medicina humana. MÉTODOS: Estudio observacional, descriptivo y retrospectivo, al que se incluyeron estudiantes de medicina humana de 18-25 años, de una universidad privada del Perú, seleccionados mediante muestreo tipo "bola de nieve" a través de mensajería electrónica. El tamaño de la muestra se calculó con el programa OpenEpi v3.0 y la fórmula de prevalencia. RESULTADOS: Se registraron 355 estudiantes, con edad media de 20.9 años (SD ± 5,01). La frecuencia de alergia alimentaria fue de 9.3% del total de la muestra; y la frecuencia de alergia a productos de consumo común (oriundos del país) reportó: mariscos 2.24%, especias y condimentos 2.24%, frutas 1.4%, leche 1.4% y carnes rojas 0.84%. CONCLUSIONES: Existe una frecuencia de 9.3% de alergia alimentaria autorreportada, producida por productos de consumo común (oriundos del Perú) a nivel nacional.