Home birth preference, childbirth, and newborn care practices in rural Peruvian Amazon.

Home birth is very common in the Peruvian Amazon. In rural areas of the Loreto region, home to indigenous populations such as the Kukama-Kukamiria, birth takes place at home constantly. This study aims to understand the preference for home births as well as childbirth and newborn care practices among Kukama-Kukamiria women in rural Loreto. Following a case study approach, sixty semi-structured, face-to-face interviews were conducted with recent mothers who experienced childbirth within one year prior to the interview, female relatives of recent mothers who had a role in childbirth, male relatives of recent mothers, community health workers, and traditional healers. We found that for women from these communities, home birth is a courageous act and an intimate (i.e. members of the community and relatives participate in it) and inexpensive practice in comparison with institutional birth. These preferences are also linked to experiences of mistreatment at health facilities, lack of cultural adaptation of birthing services, and access barriers to them. Preparations for home births included handwashing and cleaning delivery surfaces. After birth, waiting for the godparent to arrive to cut the cord can delay drying of the newborn. Discarding of colostrum, lack of skin-to-skin contact as well as a range of responses regarding immediate breastfeeding and immediate drying of the baby were also found. These findings were used to tailor the educational content of the Mamas del Rio program, where community health workers are trained to identify pregnancy early, perform home visits to pregnant women and newborns, and promote essential newborn care practices in case institutional birth is not desired or feasible. We make recommendations to improve Peru's cultural adaptation of birthing services.

Interest on the internet for systemic lupus erythematosus: Analysis of Google Trends in Latin American countries.

BACKGROUND/OBJECTIVE: Information available on the internet about Systemic Lupus Erythematosus (SLE) can influence the doctor-patient relationship. Therefore, the aim of this study was to identify the terms used for SLE on the internet. METHODS: We analyzed the data downloaded from Google Trends, considering the term "Lupus" in a six-year web-based research. The frequency of the terms for each Pan-American country was obtained automatically from Google Trends, which reports relative search volumes or RSV (on a scale from 0 to 100) across regions. RESULTS: We obtained a total of 67 registered terms in 18 countries. The terms were distributed into five categories. The categories with interest in all countries were "definition" and "symptoms". CONCLUSIONS: Google Trends allows us to find useful information about SLE on the internet; once the accuracy of this information is validated, it can be used by patients, health institutions, rheumatologists and other health professionals.

What Messages About Osteoporosis Are Offered in Spanish Videos on YouTube?

OBJECTIVE: The aim of this study was to determine the appropriateness of messages on osteoporosis in Spanish videos posted on YouTube. METHODS: YouTube Spanish language videos on osteoporosis were evaluated. The main variable was the presence of appropriate messages related to osteoporosis. The content was evaluated through a checklist based on available guidelines and reviewed by an expert (E.C.L.). The evaluation was performed twice independently for each video. A discussion of discordant messages was made with the expert. Other variables included were number of views, comments, "likes," and "dislikes"; the total duration of the video; and their source (health professionals and non-health professionals). Bivariate analysis between health professionals and non-health professionals were performed using the Mann-Whitney U and the χ tests. RESULTS: A total of 148 videos were reviewed. The median appropriate score for all videos was 5 (p25: 3, p75: 9) (maximum possible, 29 points). Seventy-three (49%) videos had a health professional as source, 124 (83.8%) mentioned at least one message in the definition area, 99 (66.9%) in the area of diagnosis, 99 (66.9%) in the area of recommendations, 43 (29.1%) in the area of treatment, and 5 (3.4%) in follow-up. The most frequent message was "risk of fracture" (68.9%). CONCLUSIONS: The content of osteoporosis information found in YouTube was generally incomplete and inaccurate. The content of these videos should include treatment and preventive strategies.

Incidencia de apendicitis aguda y su relación con factores ambientales, Perú, 2013 / Incidence of acute appendicitis and its relationship to environmental factors, Peru, 2013

La apendicitis aguda es la causa más frecuente de abdomen agudo quirúrgico. A pesar de su frecuencia, poco se conoce sobre su epidemiologia en el Perú. Objetivos. Explorar la incidencia de la apendicitis aguda y su relación con la temperatura ambiental. Diseño. Estudio ecológico de grupos múltiples. Institución. Facultad de Medicina de San Fernando, Universidad Nacional Mayor de San Marcos, Lima, Perú. Material. Registros del Ministerio de Salud y del Instituto Nacional de Estadística e Informática, Lima, Perú. Métodos. Se realizó un estudio ecológico de grupos múltiples a partir de los registros de apendicitis. Se analizó los resultados con el coeficiente correlación de Pearsony para medir la asociación se usó la regresión de Poisson. Principales medidas de resultados. Incidencia de apendicitis y temperatura media anual por departamento y razón de incidencias (IRR). Resultados. Se encontró una correlación positiva entre la temperatura y la tasa de incidencia de apendicitis (r=0,46; p=0,02). En el análisis de regresión se obtuvo una asociación significativa (p=0,01) entre la tasa de incidencia de apendicitis y la temperatura ambiental (IRR=1,04, IC: 1,01-1,08). Conclusiones. Existió asociación directa entre la incidencia de apendicitis y la temperatura ambiental...

Acute appendicitis is the most common cause of acute surgical abdomen. Despite its frequency, little is known on its epidemiology in Peru. Objectives: To determine the relation between incidence of appendicitis and environmental temperature. Design: Multiple group study. Setting: San Fernando Faculty of Medicine, Universidad Nacional Mayor de San Marcos, Lima, Peru. Material: Records from the Ministry of Health and data from the National Institute of Statistics and Informatics, Lima, Peru. Methods:An ecological study of multiple groups was performed from appendicitis records. Results were analyzed with Pearson coefficient and Poisson regression. Main outcome measures: Incidence of appendicitis and annual average temperature by department and incidence rate ratios (IRR). Results: A positive correlation between temperature and rate of incidence of appendicitis (r = 0.46; p = 0.02) was obtained. In the regression analysis a significant association (p = 0.01) between incidence rate of appendicitis and environmental temperature (IRR = 1.04, CI: 1.01-1.08) was found. Conclusion: There was direct association between incidence of appendicitis and enviromental temperature...

Caracterización de infecciones por bacterias productoras de BLEE en un hospital de referencia nacional / Characterization of ESBL-producing bacteria infections on a national referral hospital

La resistencia mediante la producción de betalactamasa de espectro extendido (BLEE) es la resistencia microbiana más común y de importancia en salud pública. Objetivos: Describir las características de las infecciones por bacterias productoras de BLEE en un hospital de referencia nacional. Diseño: Estudio transversal descriptivo. Lugar: Hospital Nacional Daniel Alcides Carrión, Callao, Perú. Materiales: Registros de los cultivos de secreciones realizados en el Laboratorio de Microbiología del HNDAC en el año 2012. Métodos: Se analizó datos del paciente (edad, sexo y servicio del cual se recibió la muestra) y datos de la muestra (fecha de obtención, el tipo de muestra, el microrganismo encontrado, el antibiograma detallado y su calificación como bacteria productora de BLEE). Principales medidas de resultados: Características de las infecciones por bacterias productoras de BLEE. Resultados: Se recolectó 3 149 muestras, 70,9 por ciento (2 235) fueron de mujeres; 29,4 por ciento fueron cultivos positivos para bacterias productoras de BLEE. Los servicios críticos obtuvieron la mayor prevalencia, y los meses donde se encontró mayor presencia fueron abril (34,7 por ciento) y julio (34,7 por ciento). Tanto E. coli (72,4 por ciento) como Klebsiella sp. (20 por ciento) fueron las prevalentes. No se encontró resistencia para imipinem, tanto para E. coli como para Klebsiella sp. Conclusiones: La prevalencia fue similar a la de América Latina (34,6 por ciento). Se presenta más evidencias de una alta presencia en consulta externa y en mayores de 46 años; siendo así un problema de salud pública...

Resistance by extended-spectrum beta-lactamase (ESBL) is the most common antimicrobial resistance and of public health importance. Objectives: To describe ESBL producing bacteria characteristics in a national reference hospital. Design: Cross sectional, descriptive study. Setting: Hospital Nacional Daniel Alcides Carrión, Callao, Peru. Materials: Records of secretion cultures done in the hospital Laboratory of Microbiology during 2012. Methods: Patient data (age, sex and service from which the sample was received) and sample data (date of collection, sample type, microorganism found, sensitivity and detailed classification as ESBLproducing bacteria) were analyzed. Main outcome measures: Characteristics of infections by ESBL-producing bacterias. Results: Study included 3 149 samples, 70.9 per cent (2 235) from female patients; 29.4 per cent were cultures positive for ESBL-producing bacteria. Critical services had the highest prevalence, and months with highest occurrence were April (34.7 per cent) and July (34.7 per cent). Both, E. coli (72.4 per cent) and Klebsiella sp. (20.0 per cent) were the most prevalent. No imipinem resistance was found for E. coli or Klebsiella sp. Conclusions: The prevalence was similar to that of Latin America (34.6 per cent). More evidence of high prevalence in outpatients and patients over 46 year-old is presented, considering it a public health problem...