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This study aimed to analyze Escherichia coli from marketed meat samples in Peru. Sixty-six E. coli isolates were recovered from 21 meat samples (14 chicken, 7 beef), and antimicrobial resistance levels and the presence of mechanisms of antibiotic resistance, as well as clonal relationships and phylogeny of colistin-resistant isolates, were established. High levels of antimicrobial resistance were detected, with 93.9% of isolates being multi-drug resistant (MDR) and 76.2% of samples possessing colistin-resistant E. coli; of these, 6 samples from 6 chicken samples presenting mcr-1-producer E. coli. Colistin-resistant isolates were classified into 22 clonal groups, while phylogroup A (15 isolates) was the most common. Extended-spectrum ß-lactamase- and pAmpC-producing E. coli were found in 18 and 8 samples respectively, with blaCTX-M-55 (28 isolates; 16 samples) and blaCIT (8 isolates; 7 samples) being the most common of each type. Additionally, blaCTX-M-15, blaCTX-M-65, blaSHV-27, blaOXA-5/10-like, blaDHA, blaEBC and narrow-spectrum blaTEM were detected. In addition, 5 blaCTX-M remained unidentified, and no sought ESBL-encoding gene was detected in other 6 ESBL-producer isolates. The tetA, tetE and tetX genes were found in tigecycline-resistant isolates. This study highlights the presence of MDR E. coli in Peruvian food-chain. The high relevance of CTX-M-55, the dissemination through the food-chain of pAmpC, as well as the high frequency of unrelated colistin-resistant isolates is reported.
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The spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, created a rapidly unfolding health crisis, especially in the initial phases of the pandemic. In the early stages of the pandemic, various strategies were proposed for COVID-19 prophylaxis and treatment with very little scientific evidence available. Among these proposed treatments were ivermectin and chlorine dioxide, which were both used widely in Peru for both disease prevention and treatment without considering their problematic side effects. For instance, ivermectin was part of an approved therapeutic scheme based on in vitro data, although its efficacy in humans was not demonstrated. In addition, chlorine dioxide was never shown to be effective but causes threatening side effects. In this article, we discuss current information regarding chlorine dioxide and ivermectin in the context of the COVID-19 pandemic, with a focus on experiences in Peru.
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Objective: Antimicrobial resistance is an increasing health problem worldwide with serious implications in global health. The overuse and misuse of antimicrobials has resulted in the spread of antimicrobial-resistant microorganisms in humans, animals and the environment. Surveillance of antimicrobial resistance provides important information contributing to understanding dissemination within these environments. These data are often unavailable in low- and middle-income countries, such as Peru. This review aimed to determine the levels of antimicrobial resistance in non-clinical Escherichia coli beyond the clinical setting in Peru. Methods: We searched 2009-2019 literature in PUBMED, Google Scholar and local repositories. Results: Thirty manuscripts including human, food, environmental, livestock, pets and/or wild animals' samples were found. The analysis showed high resistance levels to a variety of antimicrobial agents, with >90% of resistance for streptomycin and non-extended-spectrum cephalosporin in livestock and food. High levels of rifamycin resistance were also found in non-clinical samples from humans. In pets, resistance levels of 70->90% were detected for quinolones tetracycline and non-extended spectrum cephalosporins. The results suggest higher levels of antimicrobial resistance in captive than in free-ranging wild-animals. Finally, among environmental samples, 50-70% of resistance to non-extended-spectrum cephalosporin and streptomycin was found. Conclusions: High levels of resistance, especially related to old antibacterial agents, such as streptomycin, 1st and 2nd generation cephalosporins, tetracyclines or first-generation quinolones were detected. Antimicrobial use and control measures are needed with a One Health approach to identify the main drivers of antimicrobial resistance due to interconnected human, animal and environmental habitats.
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Resumen Objetivo: Analizar la literatura existente referida a los estudios relacionados con los hábitos alimenticios de los jóvenes universitarios, así como la incidencia que dichos hábitos tienen en su salud. Método: Se ha realizado una Revisión Sistemática de la Literatura, basada en los criterios propuestos por Petticrew & Roberts (2006) usando los estándares PRISMA. Se analizaron artículos de carácter práctico, indexados en las bases de datos electrónicas: Scopus, EBSCOhost y ScienceDirect, publicados en el período 2000-2020. La búsqueda inicial arrojó 2397 artículos, de los cuales 57 fueron escogidos para su revisión en profundidad, luego de aplicar los criterios de selección. Resultados: La revisión de la literatura mostró que las investigaciones han sido publicadas en revistas especializadas de las Ciencias de la Salud (28,07 %), en países como Estados Unidos (14,04 %), Arabia Saudita (14,04 %) y España (10,53 %), y empleando diseños transversales a partir de la recolección de fuentes primarias (66,67 %). Los resultados también arrojaron que los jóvenes universitarios no practican hábitos alimentarios saludables (87,72 %). De hecho, su alimentación se caracteriza por ser poco variada y de baja calidad nutricional, con un alto consumo de dulces (57,89 %), grasas (45,61 %) y comidas rápidas y ultraprocesadas (45,61 %), frente a una baja ingesta de frutas y verduras (71,93 %). Asimismo, se muestra que los malos hábitos alimenticios tienen una alta incidencia en la salud (73,91 %), tales como sobrepeso (47,21 %), enfermedades cardiovasculares (18,18 %) y Diabetes (14,55 %). Conclusiones: La revisión de la literatura arroja que existe una alta prevalencia entre los malos hábitos alimenticios y el riesgo de padecer sobrepeso y obesidad, así como de la aparición de futuras enfermedades crónicas no transmisibles, tales como las enfermedades cardiovasculares y la Diabetes.
ABSTRACT Objective: to analyze the existing literature on studies related to the eating habits of young university students, as well as the impact that these habits have on their health. To this end, a Systematic Method: A Systematic Literature Review has been carried out, based on the criteria proposed by Petticrew & Roberts (2006) using the PRISMA standards. Articles of a practical nature, indexed in the electronic databases: Scopus, EBSCOhost and ScienceDirect, published in the period 2000-2020, were analyzed. The initial search yielded 2,397 articles, of which 57 were chosen for in-depth review, after applying the selection criteria. Results: The literature review showed that the investigations have been published in specialized Health Sciences journals, in countries such as the United States (14,04 %), Saudi Arabia (14,04 %) and Spain (10,53 %), using cross-sectional designs based on the collection of primary sources (66,67 %). In addition, the results showed that university students do not practice healthy eating habits (87,72 %). In fact, their diet is characterized by being little varied and of low nutritional quality, with a high consumption of sweets (57,89 %), fats (45,61 %) and ultra-processed foods (45,61 %), compared to a low intake of fruits and vegetables (71,93 %). Furthermore, bad eating habits have a high incidence on health (73,91 %), such as being overweight (47,21 %), cardiovascular diseases (18,18 %) and Diabetes (14,55 %). Discussions: The studies reviewed showed that there is a high prevalence between poor eating habits and the risk of being overweight and obese, as well as the future appearance of non-communicable chronic diseases, such as cardiovascular diseases and Diabetes.
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Señor editor: En mayo del 2020, el Ministerio de Salud del Perú (MINSA) incluyó la ivermectina (IVM) dentro de los protocolos de manejo en pacientes con COVID-19 leve, moderado y severoa partir de los resultados de un estudio que comprobó su efectividad in vitro para inhibir la replicación de SARS-CoV-2
Dear Editor: In May 2020, the Peruvian Ministry of Health (MINSA) included ivermectin (IVM) within the management protocols for patients with mild, moderate and severe COVID-19 following the results of a study that proved its in vitro effectiveness in inhibiting SARS-CoV-2 replication.
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OBJECTIVE: to evaluate the concordance between the leadership styles self-evaluated by the Nursing managers and evaluated by their subordinates in a private hospital. METHODOLOGY: an observational, cross-sectional, quantitative, and analytical study, with population of 31 managing nurses and 125 subordinates. Herman Bachenheimer's instrument of Situational Leadership was employed, adapting it to the subordinates. The concordance between self-evaluation and evaluation by the subordinates was analyzed in the four leadership styles (Directing, Guiding, Participating, Delegating), with the Kappa coefficient statistical test, test statistic (Z) >1.96, 95% confidence interval and PASW Statistics, version 18. RESULTS: the self-evaluation of the Nursing managerial staff has a tendency for the Guiding Style and, according to the evaluation by their subordinates, there is a minimum difference among the four styles. Their concordance is low, but significant, with 19.3%. It was identified that the subordinates perceive that they possess the necessary competences to autonomously perform the tasks assigned, and that there is trust and assertive communication between both groups, which facilitates knowledge exchange. CONCLUSION: the Nursing managers and their subordinates perceive various leadership styles, and concordance is low. To attain superior leadership styles, the subordinates must develop autonomy and empowerment.
Subject(s)
Nurse Administrators , Nursing Staff, Hospital , Nursing Staff , Cross-Sectional Studies , Diagnostic Self Evaluation , Humans , LeadershipABSTRACT
Objective: to evaluate the concordance between the leadership styles self-evaluated by the Nursing managers and evaluated by their subordinates in a private hospital. Methodology: an observational, cross-sectional, quantitative, and analytical study, with population of 31 managing nurses and 125 subordinates. Herman Bachenheimer's instrument of Situational Leadership was employed, adapting it to the subordinates. The concordance between self-evaluation and evaluation by the subordinates was analyzed in the four leadership styles (Directing, Guiding, Participating, Delegating), with the Kappa coefficient statistical test, test statistic (Z) >1.96, 95% confidence interval and PASW Statistics, version 18. Results: the self-evaluation of the Nursing managerial staff has a tendency for the Guiding Style and, according to the evaluation by their subordinates, there is a minimum difference among the four styles. Their concordance is low, but significant, with 19.3%. It was identified that the subordinates perceive that they possess the necessary competences to autonomously perform the tasks assigned, and that there is trust and assertive communication between both groups, which facilitates knowledge exchange. Conclusion: the Nursing managers and their subordinates perceive various leadership styles, and concordance is low. To attain superior leadership styles, the subordinates must develop autonomy and empowerment.
Objetivo: avaliar a concordância entre os estilos de liderança autoavaliados pelos gerentes de enfermagem e avaliados pelos próprios liderados em um hospital privado. Método: estudo observacional, transversal, quantitativo e analítico, com população de 31 enfermeiras gestoras e 125 liderados. Foi utilizado o instrumento de Liderança Situacional de Herman Bachenheimer, adaptando-o para os liderados. Foi analisada a concordância entre a autoavaliação e a avaliação dos liderados nos quatro estilos de liderança (Determinar, Persuadir, Compartilhar, Delegar), com o teste de significância estatística coeficiente Kappa, teste estatístico (Z)> 1,96, intervalo de confiança de 95 % e programa PASW Statistics versão 18. Resultados: a autoavaliação dos gerentes de enfermagem tende ao estilo Persuadir e, de acordo com a avaliação de seus liderados, existe diferença mínima entre os quatro estilos. A concordância é pobre, porém significativa com 19,3%. Identificou-se que os liderados consideram-se a si mesmos como possuidores das competências necessárias para realizar as tarefas atribuídas com autonomia, há confiança e comunicação assertiva entre ambos os grupos, o que facilita a troca de conhecimentos. Conclusão: os gerentes de enfermagem e seus liderados reconhecem diferentes estilos de liderança e a concordância é pobre. Para alcançar estilos de liderança superiores, os liderados devem desenvolver autonomia e empoderamento.
Objetivo: evaluar la concordancia entre los estilos de liderazgo autoevaluados por los directivos de enfermería y evaluados por sus propios seguidores en un hospital privado. Método: estudio observacional, transversal, cuantitativo y analítico con población de 31 enfermeras directivas y 125 seguidores. Se empleó el instrumento de Liderazgo Situacional de Herman Bachenheimer, adaptándolo para los seguidores. Se analizó la concordancia entre la autoevaluación y evaluación de los seguidores en los cuatro estilos de liderazgo (Dirigir, Guiar, Participar, Delegar), con la prueba estadística coeficiente de Kappa, estadístico de prueba (Z) >1,96, intervalo de confianza del 95% y programa PASW Statistics versión 18. Resultados: la autoevaluación del personal directivo de enfermería tiende al estilo Guiar y, según la evaluación por sus seguidores, hay mínima diferencia entre los cuatro estilos. Su concordancia es pobre, pero significativa con el 19,3%. Se identificó que los seguidores se perciben con las competencias necesarias para realizar con autonomía las tareas asignadas, existe confianza y comunicación asertiva entre ambos grupos, lo que facilita intercambio de conocimientos. Conclusión: los directivos de enfermería y sus seguidores perciben diversos estilos de liderazgo, y la concordancia es pobre. Para alcanzar estilos de liderazgo superiores, los seguidores deben desarrollar autonomía y empoderamiento.