Factors associated with mental health in Peruvian medical students during the COVID-19 pandemic: a multicentre quantitative study.

OBJECTIVE: To assess the mental health status and associated factors of Peruvian medical students during the COVID-19 pandemic. METHODS: Descriptive, multicentre, correlational study that used the "Patient Health Questionnaire-9 (PHQ-9)", the "Generalized Anxiety Disorder-7 (GAD-7)" and the "Impact of Event Scale-Revised (IES-R)" questionnaires to evaluate mental health problems. RESULTS: A total of 1,238 students from 8 Peruvian medical schools participated in the study. Of these, 68.5% were women, and the mean age was 21.4 years. Depressive symptoms were found in 74% of the participants, anxiety symptoms in 57% and distress symptoms in 65%. The variables associated with the development of symptoms of moderate-severe depression, anxiety and distress were: not having family economic stability, being in the first years of medical training, being female, and fearing that their medical training would be delayed and impaired. CONCLUSIONS: In a sample of medical students surveyed during the COVID-19 pandemic, mental health problems were common. The factors associated with mental health reported in this study could be useful in identifying vulnerable medical students who require timely psychosocial support and/or psychiatric care.

Factors associated with suicidal ideation among medical students during the initial phase of the COVID-19 pandemic in Peru: A multicenter study.

We aimed to describe the prevalence and factors associated with suicidal ideation in a sample of 1238 medical students from different medical schools in Peru based on question 9 of the Patient Health Questionnaire (PHQ-9). Our results revealed that 17.9% of the participants had suicidal ideation. Furthermore, using logistic regression, we found that not practicing any religion, the presence of clinically significant depression, and the presence of clinically significant anxiety were statistically related to the presence of suicidal ideation. Our results indicate that suicidal ideation was highly prevalent in the sample of medical students studied.

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.

Psychometric properties of the Spanish version of the fear of COVID-19 scale in Peruvian medical students.

The Coronavirus Disease 2019 (COVID-19) pandemic continues to produce significant emotional consequences at the individual, community, societal, and global levels. This study describes the psychometric properties of the Spanish version of the Fear of COVID-19 Scale (FCV-19S) in Peruvian medical students. Data were collected by a convenience sampling method, resulting in a total of 1238 medical students from different medical schools in Peru. Our analyses suggest that a two-factor model explains the underlying two-dimensional structure of the FCV-19S. The results indicated that the Spanish version of the FCV-19S scale was found to have adequate psychometric properties.

Sobrevida de un paciente adulto mayor con cáncer de pulmón, tratado con quimioterapia de primera línea

RESUMEN Introducción: El cáncer de pulmón está afectando cada vez más a la población de adultos mayores, a medida que la expectativa de vida aumenta. Sin embargo, es difícil establecer la eficacia de la quimioterapia y el pronóstico de estos pacientes es grave. Objetivo: Presentar un caso de paciente adulto mayor con cáncer de pulmón avanzado de células no pequeñas, con una prolongada sobrevida que recibió solamente quimioterapia de primera línea. Caso clínico: Paciente no fumador, de 71 años, diagnosticado con cáncer de pulmón de células no pequeñas avanzado, del subtipo adenocarcinoma, con compromiso pleural. Inició tratamiento con carboplatino 5 AUC y gemcitabina 1,1 g. En el noveno ciclo, se encontró reducción de los nódulos pulmonares, pero también metástasis en el nivel D6-D7. Inició la segunda línea de tratamiento con carboplatino 5,4 AUC, paclitaxel 200 mg y ácido zolendrónico en dosis de 4,0 mg. Debido a eventos adversos, el tratamiento fue cambiado a vinorelbina 2,5 g y ácido zolendrónico 4,0 mg. Tras dos ciclos, el paciente fallece, alcanzando 21 meses de sobrevida global, solo con quimioterapia. Conclusión: El tratamiento del paciente adulto mayor con cáncer de pulmón es complejo. En el presente esquema de quimioterapia, el paciente pudo alcanzar 21 meses de sobrevida global, a pesar de que no fue caracterizado molecularmente.

ABSTRACT Introduction: Lung cancer is taking an increasing toll on the older population as life expectancy increases. However, the efficacy of chemotherapy is difficult to establish and the prognosis of these patients is severe. Objective: Report a case of an older adult patient with advanced non-small cell lung cancer with prolonged survival who received only first-line chemotherapy. Case report: A 71-year-old non-smoker patient diagnosed with advanced non-small cell lung cancer, adenocarcinoma subtype, with pleural involvement. He started treatment with carboplatin 5 AUC and gemcitabine 1,1 g. In the ninth cycle, reduction of pulmonary nodules was found, but he also had metastases at the D6-D7 level. He started the second line of treatment with carboplatin 5,4 AUC, paclitaxel 200 mg and zolendronic acid at a dose of 4,0 mg. Due to adverse events, the treatment was changed to vinorelbine 2,5 g and zolendronic acid 4.0 mg. After two cycles, the patient died, reaching 21 months of overall survival, only with chemotherapy. Conclusion: The treatment of the older adult patient with lung cancer is challenging. In the present chemotherapy treatment, the patient was able to achieve 21 months of overall survival, despite the fact that he was not molecularly characterized.

Factors associated with mental health in Peruvian medical students during the COVID-19 pandemic: a multicentre quantitative study.

OBJECTIVE: To assess the mental health status and associated factors of Peruvian medical students during the COVID-19 pandemic. METHODS: Descriptive, multicentre, correlational study that used the "Patient Health Questionnaire-9 (PHQ-9)", the "Generalized Anxiety Disorder-7 (GAD-7)" and the "Impact of Event Scale-Revised (IES-R)" questionnaires to evaluate mental health problems. RESULTS: A total of 1,238 students from 8 Peruvian medical schools participated in the study. Of these, 68.5% were women, and the mean age was 21.4 years. Depressive symptoms were found in 74% of the participants, anxiety symptoms in 57% and distress symptoms in 65%. The variables associated with the development of symptoms of moderate-severe depression, anxiety and distress were: not having family economic stability, being in the first years of medical training, being female, and fearing that their medical training would be delayed and impaired. CONCLUSIONS: In a sample of medical students surveyed during the COVID-19 pandemic, mental health problems were common. The factors associated with mental health reported in this study could be useful in identifying vulnerable medical students who require timely psychosocial support and/or psychiatric care.

Factors related to depression in older adults during the COVID-19 pandemic in two coastal regions of Peru: An analytical cross-sectional study.

Background: Mental health problems such as anxiety, depression and their aggravation have been studied extensively in the general population. However, there are few studies on depression in older adults and the few existing results may be contradictory, especially in the context of the COVID-19 pandemic. The aim of this study is to determine the factors associated with depression in older adults in two coastal regions of Peru during the COVID-19 pandemic. Methods: This study uses an analytical cross-sectional design in a population of older adults, who participated in a non-governmental ambulatory social support program in Callao and Ica, two coastal regions of Peru. We administered an on-site structured questionnaire to record sociodemographic data, the Geriatric Depression Scale by Yesavage to measure depression, and the Barthel Index to assess physical function. In order to determine cognitive impairment as an exclusion criterion, the MEC-30 was used. The association between variables was assessed through contingency tables, using the odds ratio (OR) with its corresponding confidence interval (95% CI) and the X2 test. Finally, a binary logistic regression analysis was performed. Results: Out of the 244 older adults surveyed, 39% had depressive symptoms, of which 28.3% (n=69) and 10.7% (n=26) were moderately and severely depressive, respectively. The findings significantly associated with the presence of depressive symptoms were being 76 years old or older [p=0.005, OR: 2.33, 95% CI: 1.29-4.20], not participating in weekly recreational activities [p=0.004, OR: 2.28, 95% CI: 1.31-3.99] and the presence of comorbidities [p=0.026, OR: 1.88, 95% CI: 1.07-3.29]. Conclusion: There are few studies exploring depression in older adults during the COVID-19 pandemic; this research shows the importance of mental health care in this population and, particularly, of those who are 76 or older because they suffer from comorbid conditions and have interrupted recreational activities.

Caso de publicación duplicada sobre complicaciones posquirúrgicas en pacientes operados por hernias inguinales / Case of duplicate publication about post-surgical in patients with complications of inguinal hernias

Recientemente leímos con interés el artículo publicado por Saliou y otros, titulado Factores asociados a las complicaciones de la cirugía electiva de las hernias inguinales1 (artículo I) en el cual describen las características asociadas a las complicaciones posquirúrgicas, de pacientes atendidos por hernias inguinales, en el Servicio de Cirugía General del Hospital Provincial Docente Saturnino Lora, de una ciudad de Cuba. Sin embargo, este trabajo publicado en la Revista Cubana de Medicina Militar presenta resultados similares a otro publicado previamente en la Revista Cubana de Cirugía, realizado por los mismos autores, cuyo título es "Complicaciones posquirúrgicas de las hernias inguinales"2 (artículo II). Al analizar el contenido de ambos artículos, siguiendo las directrices del Comité Internacional de Directores de Revistas Biomédicas (ICMJE),3 el artículo I sería una publicación duplicada, porque no muestra una clara diferencia entre ambos trabajos, ni cita adecuadamente al artículo II. Además, existe una superposición notoria de los resultados que fueron presentados en ambos trabajos. Esto genera problemas, porque se podría contabilizar inadvertidamente a ambos resultados, lo cual crea un escenario epidemiológico sesgado para posteriores investigaciones. Para que un trabajo sea considerado como una publicación secundaria autorizada, el artículo I debería cumplir las siguientes características: i) la publicación secundaria debería estar dirigido a diferentes lectores, ii) la publicación secundaria debería informar que se basa en un trabajo publicado anteriormente mediante una nota o cita y iii) el título de la publicación secundaria también debería señalar de que se trata de una versión secundaria.3 Esto no se evidencia en el artículo I, a pesar de que el artículo II ya estaba publicado (fecha de aprobación: octubre del 2019 vs fecha de publicación: abril - junio del 2019, respectivamente). En el caso de tratarse de manuscritos basados en la misma base de datos, que también contempla el ICMJE,3 el método analítico y las conclusiones deberían ser marcadamente diferentes, sin embargo, esto no queda claro entre ambos manuscritos. Si bien el artículo I efectúa una asociación entre las complicaciones posquirúrgicas, y algunas características de los pacientes operados por hernias inguinales, y el artículo II solo describe las características de las complicaciones posquirúrgicas de estos pacientes, se observa una aparente omisión intencional de datos en el artículo II, para poder dar estas ligeras diferencias entre ambos artículos. En este artículo no se presentan datos iniciales tales como edad, sexo y antecedentes clínicos necesarios para una mejor comprensión de los resultados. Todas estas características de los pacientes, solo aparecen para el análisis del...(AU)