Producción científica en insuficiencia cardiaca en Perú: un estudio bibliométrico / Scientific production in heart failure in Peru: a bibliometric study

Resumen Objetivo: Analizar la producción científica peruana sobre insuficiencia cardiaca (IC) en el periodo 2000-2020. Material y métodos: Se realizó un estudio observacional bibliométrico en la base de datos de Scopus y Scielo de documentos publicados sobre IC por algún autor con filiación peruana entre los años 2000 y 2020. Se analizaron de manera descriptiva las variables de producción científica, número de publicaciones anuales, documentos, características de las publicaciones e instituciones. Se analizaron las redes colaborativas, construyéndose una red de nodos utilizando el software VOSViewer v1.6.5. Resultados: Se encontró 236 publicaciones en Scopus y 55 en Scielo. El mayor número de documentos fueron artículos originales seguido de artículos de revisión. The Lancet y la Revista Peruana de Medicina Experimental y Salud Pública fueron las que tuvieron el mayor número de publicaciones. Se registraron 31 países que tuvieron al menos cinco documentos publicados con un autor del Perú. La colaboración científica fue principalmente con EE.UU. y a nivel regional con Argentina. Se publicaron 55 documentos con solo autores peruanos. Conclusiones: La producción científica en IC de autores peruanos se encuentra en crecimiento exponencial. Y es la Universidad Peruana Cayetano Heredia/Crónicas la institución peruana con más publicaciones sobre esta.

Abstract Objective: To analyze the Peruvian scientific production on Heart Failure (HF) in the period 2000-2020. Methods: We performed an observational bibliometric study, in the Scopus and Scielo database, of documents published on heart failure by an author with Peruvian affiliation, between the years 2000 and 2020. We describe variables of scientific production, number of annual publications, documents, characteristics of the publications, and institutions. The collaborative networks were analyzed by building a network of nodes using the VOSViewer v1.6.5 software. Results: A 236 publications were found in Scopus and 55 in Scielo. The largest number of documents were original articles followed by review articles. The journal "The Lancet" and "Revista Peruana de Medicina Experimental y Salud Pública" were those that had the highest number of publications. Thirty-one countries were registered that had at least 5 documents published with an author from Peru. Scientific collaboration was mainly with the United States and at the regional level with Argentina. 55 documents were published with only Peruvian authors. Conclusion: The scientific production in HF by Peruvian authors is in exponential growth. And the Universidad Peruana Cayetano Heredia/CRÓNICAS is the Peruvian institution with the most publications on it.

Scientific production in heart failure in Peru: a bibliometric study.

OBJECTIVE: To analyze the Peruvian scientific production on Heart Failure (HF) in the period 2000-2020. METHODS: We performed an observational bibliometric study, in the Scopus and Scielo database, of documents published on heart failure by an author with Peruvian affiliation, between the years 2000 and 2020. We describe variables of scientific production, number of annual publications, documents, characteristics of the publications, and institutions. The collaborative networks were analyzed by building a network of nodes using the VOSViewer v1.6.5 software. RESULTS: A 236 publications were found in Scopus and 55 in Scielo. The largest number of documents were original articles followed by review articles. The journal "The Lancet" and "Revista Peruana de Medicina Experimental y Salud Pública" were those that had the highest number of publications. Thirty-one countries were registered that had at least 5 documents published with an author from Peru. Scientific collaboration was mainly with the United States and at the regional level with Argentina. 55 documents were published with only Peruvian authors. CONCLUSION: The scientific production in HF by Peruvian authors is in exponential growth. And the Universidad Peruana Cayetano Heredia/CRÓNICAS is the Peruvian institution with the most publications on it.

OBJETIVO: Analizar la producción científica peruana sobre insuficiencia cardiaca (IC) en el periodo 2000-2020. MATERIAL Y MÉTODOS: Se realizó un estudio observacional bibliométrico en la base de datos de Scopus y Scielo de documentos publicados sobre IC por algún autor con filiación peruana entre los años 2000 y 2020. Se analizaron de manera descriptiva las variables de producción científica, número de publicaciones anuales, documentos, características de las publicaciones e instituciones. Se analizaron las redes colaborativas, construyéndose una red de nodos utilizando el software VOSViewer v1.6.5. RESULTADOS: Se encontró 236 publicaciones en Scopus y 55 en Scielo. El mayor número de documentos fueron artículos originales seguido de artículos de revisión. The Lancet y la Revista Peruana de Medicina Experimental y Salud Pública fueron las que tuvieron el mayor número de publicaciones. Se registraron 31 países que tuvieron al menos cinco documentos publicados con un autor del Perú. La colaboración científica fue principalmente con EE.UU. y a nivel regional con Argentina. Se publicaron 55 documentos con solo autores peruanos. CONCLUSIONES: La producción científica en IC de autores peruanos se encuentra en crecimiento exponencial. Y es la Universidad Peruana Cayetano Heredia/Crónicas la institución peruana con más publicaciones sobre esta.

Evaluating three biomarkers as prognostic factors of in-hospital mortality and severity in heart failure: A prospective cohort.

OBJECTIVE: To identify the relationship between red blood cell distribution width (RDW, %), interleukin-6 (IL-6) (pg/ml), high sensitivity-c-reactive protein (hs-CRP) (mg/l), in-hospital mortality and disease severity among patients with heart failure (HF). METHODS: Prospective cohort. We included adults diagnosed with acute non-ischemic HF in 2015. The dependent variables were in-hospital mortality (yes or no) and disease severity. The latter was assessed with the Get With The Guidelines-HF score. We used hierarchical regression models to describe the pattern of association between biomarkers, mortality, and severity. We used the Youden index to identify the best cut-off for mortality prediction. RESULTS: We included 167 patients; the mean age was 72.61 (SD: 11.06). The majority of patients presented with New York Heart Association classification II (40.12%) or III (43.11%). After adjusting for age and gender, all biomarkers were associated with mortality. After adding comorbidities, only IL-6 was associated. The final model with all clinical variables showed no effect from any biomarker. The best cut-off for RDW, hs-CRP and IL-6 for mortality were 14.8, 68.7 and 52.9, respectively. IL-6 presented the highest sensitivity (100%), specificity (75.35%) and area under the curve (0.91). CONCLUSIONS: No biomarker is independent from the most important clinical variables; therefore it should not be used for management modifications.

Red blood cell distribution width to predict mortality in heart transplant recipients: a systematic review.

Red blood cell distribution width (RDW) has been shown to have prognostic value in a number of different clinical settings, such as cardiovascular disease, including heart failure. However, its prognostic value in heart transplant (HT) recipients remains unknown. The aim of this systematic review is to determine the prognostic value of pre-transplant RDW for mortality in HT recipients. There is a pre-published protocol of this review. The terms "Heart transplant", "Red cell distribution width" and their synonyms were used in the search strategy. PubMed/Medline, Embase, Scopus, Web of Science and LILACS were searched until May 17th, 2022, without date or language restrictions. Two authors independently carried out the selection, first by title and abstract, second by full-text revision. Discrepancies were discussed and resolved with three other authors. Quality of individual studies was assessed with Newcastle Ottawa Scale (NOS) for cohorts. After removing the duplicates, 3885 articles were identified. Four articles were included in the qualitative synthesis. Three studies were classified as "good quality": whereas one as "poor quality" according to NOS scale. All the included articles evaluated long-term mortality and one study also evaluated short-term mortality. In this one, a correlation between higher RDW values and short-term mortality was reported. Meanwhile, in all the studies, a high pre-HT RDW was a marker of long-term mortality following cardiac transplantation. Our review shows that an elevated on-admission RDW is associated with long-term mortality in heart transplantation recipients.

When Frequent (Pandemic) Occurs in a Non-Frequent Disease: COVID-19 and Fabry Disease: Report of Two Cases.

Fabry disease (FD), like COVID-19, can affect multiple organs, including the lungs. Patients with FD are expected to develop severe COVID-19, due to involvement of not only the lungs but also the kidneys and the presence of other comorbidities. We present 2 cases of mild COVID-19 in patients with FD who were infected with the COVID-19 virus. Although it is unknown whether the X chromosome mutation in patients with FD affects the development of severe COVID-19, it is suggested that it may play a protective role against COVID-19 infection. Based on these cases, we suggest that FD is not a risk factor for severe COVID-19.

Educación médica a distancia en tiempos de COVID-19 / Distance medical education in the times of COVID-19

La pandemia COVID-19 ha ocasionado la suspensión de la educación médica presencial, por lo que se le ha otorgado mayor importancia a la educación médica a distancia. Esto ha producido un debate sobre cuáles son las mejores acciones a seguir. De ahí que sea importante revisar las estrategias implementadas en diversas escuelas de medicina durante epidemias previas y, a partir de ello, plantear propuestas acordes con la realidad latinoamericana, tomando en cuenta la distinción entre cursos preclínicos y clínicos. En Latinoamérica, las propuestas para lograr una adecuada enseñanza médica a distancia en el presente escenario son: la inclusión y el uso de cursos de herramientas virtuales, la implementación del aprendizaje basado en problemas, la interacción a distancia con el docente a través de medios de comunicación en línea, evitar el uso excesivo de clases grabadas, el adecuado acceso de banda ancha y vencer la resistencia docente al uso de tecnologías de la información y la comunicación en la educación médica, para buscar la interactividad y comunicación estrecha con los alumnos(AU)

The COVID-19 pandemic has stopped face-to-face medical education; therefore, greater importance has been given to distance medical education. This has provoked a debate about what the best actions to follow are. Hence, it is important to review the strategies implemented in several medical schools during previous epidemics and, based on this, make proposals in line with the Latin American reality, taking into account the distinction between preclinical and clinical courses. In Latin America, the proposals to achieve adequate distance medical education in the present scenario are the inclusion and use of virtual tool courses, the implementation of problem-based learning, distance interaction with the professor through online communication media, to avoid excessive use of recorded classes, adequate broadband access, and to overcome the professor's resistance to using information and communication technologies in medical education, seeking interaction and close communication with students(AU)

Características de los componentes del síndrome metabólico en pacientes con glucosa normal y disglicemia en ayunas / Characteristics of the components of the metabolic syndrome in patients with normal glucose and fasting disglicemia

Objetivos: Investigar las características de los componentes del Síndrome Metabólico (SM) entre pacientes con glucosa normal y disglicemia en ayunas en la población adulta de Trujillo. Material y métodos: Estudio de análisis secundario tipo descriptivo, comparativo, relacional. Se analizó base de datos, de un estudio previo sobre SM en adultos de 20-79 años en Trujillo entre los años 2010 al 2014, desarrollado a través de campañas médicas de despistaje de factores de riesgo cardiovascular. El grupo 1: incluyó 127 adultos con SM y glucosa normal en ayunas (NG). El grupo 2: incluyó 110 adultos con SM y disglicemia en ayunas (DG). Se usó la prueba t de Student para comparación de medias y la prueba Z para comparación de proporciones, con un nivel de significancia de 0,05 e intervalos de confianza del 95%. Resultados: Los niveles séricos de triglicéridos en ayunas (TG) fueron 219,09 ±101,83 mg/dl en NG y 192,3 ± 103,17 mg/dl en DG (p= 0,004) y la frecuencia de hipertrigliceridemia fue 85,04% en NG y 63,64% en DG (p=0,000) y de HDL colesterol bajo 71,65% en NG y 51,81% en DG (p=0,002). Conclusiones: Existe mayor nivel sérico de TG y mayor frecuencia de hipertrigliceridemia y HDL colesterol bajo en el grupo NG. (AU)

Objectives: To investigate the characteristics of the components of metabolic syndrome (MS) among patients with normal glucose and fasting dysglycemia in the adult population of Trujillo. Methods: Secondary analysis of descriptive, comparative and relational type. Database was analyzed of MS previous study in adults of 20-79 years in Trujillo between 2010 to 2014, developed through medical screening campaigns cardiovascular risk factors. Group 1: MS included 127 adults with normal fasting glucose (NG). The group 2 included 110 adults with MS and dysglycemia fasting (DG). Student t test was used to compare means and the Z test to compare proportions, with a significance level of 0.05 and confidence intervals of 95%. Results: Serum levels of fasting triglyceride (TG) were (219.09 ± 101.83 mg/dl and 192.3 ± NG 103.17 mg/dl in DG, p= 0.004) and frequency of hypertriglyceridemia was (85.04% and 63.64% in NG in DG with p =0.000) and low HDL cholesterol (71.65% and 51.81% in NG in DG, p=0.002). Conclusions: Higher level of TG and increased frequency of hypertriglyceridemia and low HDL cholesterol in the NG group. (AU)

Current clinical practice guidelines in atrial fibrillation: a review.

The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in atrial fibrillation. This is the second in a series of articles of review, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Among all clinical practice guidelines, we selected the American, Canadian and NICE (National Institute for Health and Care Excellence) guidelines. We used the AGREE (Appraisal of Guidelines for Research and Evaluation) II instrument for the assessment. In general, the guidelines obtained the lowest score in the applicability domain (mean 36.1%); while the highest score was for clarity of presentation (mean 93.5%). The lowest percentage was found in the editorial independence domain (Canadian guideline) and the highest of all scores in the applicability domain (NICE guideline). Regarding global quality, the NICE guideline obtained the AGREE II instrument best scores, followed by the American guideline, both recommended for use without modifications.

El objetivo del presente estudio es la evaluación metodológica de las guías de práctica clínica en fibrilación auricular. Este es el segundo de una serie de artículos de revisión, análisis, valoración metodológica y contenido de las guías de práctica clínica en cardiología. De todas las guías de práctica clínica se seleccionaron la Guía Americana, Canadiense y la del National Institute for Health and Care Excellence, (NICE, por su sigla en inglés), y se utilizó el instrumento Appraisal of Guidelines for Research and Evaluation (AGREE II) para evaluar cada una de ellas En general, las guías obtuvieron el menor puntaje en el dominio de aplicabilidad (media 36,1%); mientras que el mayor puntaje fue para el dominio de claridad en la presentación (media 93,5%). El menor puntaje hallado fue en el dominio de independencia editorial (Guía Canadiense) y el mayor de todos los puntajes fue en el dominio “Claridad de la presentación” (guía The National Institute for Health and Care Excellence, NICE). Al evaluar la calidad global de las guías de práctica clínica analizadas, NICE es la que mejor puntuaciones obtiene al aplicar el instrumento Appraisal of Guidelines for Research and Evaluation II (AGREE), seguido de la americana, siendo ambas recomendadas sin modificaciones.

Impacto de la cintura hipertensiva en el riesgo coronario y cumplimiento de la meta colesterol LDL en adultos de Trujillo / Impact of hypertensive waist in coronary risk and compliance with the LDL cholesterol target in adults of Trujillo

La determinación de la cintura hipertensiva (CH) es propuesta como la primera etapa para el despistaje de síndrome metabólico y riesgo coronario. Objetivo. Determinar el impacto de la CH en el riesgo coronario y cumplimiento de la meta colesterol LDL en adultos de Trujillo, Perú. Pacientes y Método. Estudio descriptivo, observacional, analítico, prospectivo realizado en 552 personas, 276 varones y 276 mujeres dividido en grupos etarios de 20­39, 40­59, 60­79 años. Se determinaron la presión arterial, cintura, glicemia y perfil lipídico. Se consideró CH si PAS menor igual a 130 mm Hg, PAD menor igual a 85 mmHg o antecedentes de hipertensión arterial, y cintura menor igual a 94 cm en varones y menor igual a 80 cm en mujeres; las categorías de riesgo coronario y las metas de LDL según el Adult Treatment Panel III. Resultados. 126 personas con CH (23,14%), 55 varones (19,92%) y 71 mujeres (26,44%); la categoría baja fue 27,27% en varones y 39,73% en mujeres; la alta, 30,91 y 15,07%, respectivamente. Sin CH, la categoría de riesgo baja fue en varones 65,16% y en mujeres 84,65% y la alta 10,41 y 4,95% respectivamente. El cumplimiento de la meta de LDL fue: con CH en varones 56,36%, mujeres 31,51%; sin CH 87,33 y 72,77% respectivamente. Conclusiones. El impacto de la presencia de cintura hipertensiva es expresado al encontrar una mayor frecuencia de categoría de riesgo moderadamente alto y alto y un menor cumplimiento de la meta LDL en las categorías de riesgo bajo, moderado y moderadamente alto...

Hypertensive waist (HW) have been reported as the first step of screening for metabolic syndrome and coronary risk. Objective. To determine the Impact of HW in coronary risk and compliance with the LDL cholesterol target in adults of Trujillo, Perú. Patients and Method. Descriptive, observational, analytic and prospective study. 552 people, 276 men and 276 women divided in groups of 20­39, 40­59 and of 60­79 years old. Blood pressure, waist, blood glucose and lipid profile were determined. HW was considered if systolic BP menor o igual a 130mm Hg, PAD menor o igual a 85mm Hg or hypertension history, waist menor o igual a 94 cm in men and menor o igual a 80 cm in women; the coronary risk level and LDL goal according to Adult Treatment Panel III. Results:. 126 HW cases (23.14%), 55 in men (19.92%) and 71 in women (26.44%). In HW men the low level of risk coronary was 27.27% and 39.73% in women, however the high level were 30.91% and 15.07% respectively. In without HW men the low level of risk coronary was 65.16% and 84.65% in women, and the high level 10.41 and 4,95% respectively. The LDL cholesterol goals in HW men was achieved in 56.36% and 31.51% in women, and in people without HW were 87.33% and 72.77% respectively. Conclusions: The impact of the presence of hypertensive waist is expressed on having found a major frequency of category of risk moderately high and high and a minor compliance of the LDLC cholesterol goal in the categories of low, moderate and moderately high risk...

Henoch Schonlein purpura associated with bee sting: case report.

Henoch Schonlein purpura (HSP) is a common childhood vasculitis, characterized by a non-thrombocytopenic palpable purpura and systemic features. It can be triggered by conditions like infections and insect bites. We present the case of a six-year-old girl with palpable maculopapular lesions on the lower limbs, itching, mild pain, swelling of feet, limitation of limb mobility, and a history of bee sting. Thigh skin biopsy was performed, with a report of leucocytoclastic vasculitis, and was diagnosed as HSP. She was prescribed bed rest, and was given oral hydration. The patient outcome was favorable and was discharged after five days. This is the fifth report of a HSP case associated with a bee sting with an uncomplicated course, which is in contrast to previous case reports.

La púrpura de Henoch Schonlein es una vasculitis común en la infancia, caracterizada por una púrpura palpable no trombocitopénica y manifestaciones sistémicas. Está relacionada con patologías desencadenantes como las infecciones y las picaduras de insectos. Presentamos el caso de una escolar de 6 años, de sexo femenino, con lesiones maculopapulares palpables en miembros inferiores, prurito, dolor leve, edema de pies, limitación al movimiento y antecedente de picadura de abeja. Se realizó biopsia cutánea de muslo con reporte de vasculitis leucocitoclástica y se diagnosticó como púrpura de Henoch Schonlein. Se indicó reposo y se le administró hidratación oral. Evolucionó favorablemente y fue dada de alta a los cinco días. Este es el quinto caso de púrpura de Henoch Schonlein asociado a picadura de abeja, la que se presentó sin complicaciones a diferencia de los reportes de caso previos.

Clinical practice guidelines in hypertension: a review.

The aim of this study is the methodological evaluation of Clinical Practice Guidelines (CPG) in hypertension. This is the first in a series of review articles, analysis, assessment in methodology and content of clinical practice guidelines in Cardiology. Of all clinical practice guidelines, three were selected and the Appraisal of Guidelines for Research and Evaluation (AGREE II) instrument was used to assess each guide. The guidelines obtained the lowest score in the domain of applicability (mean 43.8%); while the highest score was for clarity of presentation (mean 81.5%). The lowest percentage was found in the applicability domain (European guideline) and the highest of all scores was found in two domains: scope and purpose, and clarity of presentation (Canadian guideline). Assessing the quality of the clinical practice guidelines analyzed, the Canadian is one with the best scores obtained by applying the AGREE II instrument, and it is advised to be used without modifications.

El objetivo del presente estudio es la evaluación metodológica de las guías de práctica clínica en hipertensión arterial. Este es el primero de una serie de artículos de revisión, análisis, valoración metodológica y contenido de las guías de práctica clínica en cardiología. De todas estas guías se seleccionaron tres y se utilizó el instrumento Appraisal of Guidelines for Research and Evaluation (AGREE II) para evaluar cada guía. Las guías obtuvieron el menor puntaje en el dominio de aplicabilidad (media 43,8%); mientras que el mayor puntaje fue para el dominio de claridad en la presentación (media 81,5%). El menor porcentaje hallado fue en el dominio de aplicabilidad (Guía Europea) y el mayor de todos los puntajes fue hallado en dos dominios: alcance y objetivo, y claridad en la presentación (Guía Canadiense). Al evaluar la calidad de las guías de práctica clínica analizadas, la canadiense es la que mejor puntuaciones obtiene al aplicar el instrumento Appraisal of Guidelines for Research and Evaluation (AGREE II), siendo recomendada sin modificaciones.