Factores asociados al bloqueo de rama derecha en adultos mayores / Factors associated with right bundle branch block in older adults

RESUMEN Introducción: Existe poca literatura sobre la asociación entre el bloqueo de rama derecha y factores de riesgo como la hipertensión y la diabetes en pacientes de Latinoamérica y Perú. Objetivo: Determinar los factores asociados al bloqueo de rama derecha en adultos mayores. Métodos: Estudio transversal que incluyó 376 pacientes adultos mayores atendidos en el Hospital Almanzor Aguinaga Asenjo, Lambayeque-Perú. La variable dependiente fue la presencia de bloqueo de rama derecha y las variables independientes fueron edad, sexo, antecedente de hipertensión arterial y diabetes. Se estimaron razones de prevalencia e intervalos de confianza al 95 %. Resultados: De 376 pacientes, la mayoría eran varones (55,9 %), la edad media fue de 75,6 años, el 11,4 % tuvo antecedente de hipertensión y el 9 % era diabético. El 41 % tuvo diagnóstico de bloqueo de rama derecha. En la regresión múltiple; el sexo femenino (RP=1,53, IC 95 %: 1,21 - 1,95), antecedente de hipertensión (RP=1,55; IC 95 %: 1,21 - 2,00) y diabetes mellitus (RP=1,49, IC 95 %: 1,12 - 2,00) se asociaron de forma positiva a presentar bloqueo de rama derecha. El modelo anidado seleccionó las variables: sexo femenino (RP=1,54, IC 95 %: 1,21 - 1,96) y antecedente de hipertensión arterial (RP=1,61, IC 95 %: 1,25 - 2,08). Conclusión: El sexo femenino, antecedente de hipertensión arterial y de diabetes mellitus se asocian positivamente a presentar bloqueo de rama derecha.

ABSTRACT Introduction: There is little literature on the association between right bundle branch block and risk factors such as hypertension and diabetes in patients in Latin America and Peru. Objective: To determine the factors associated with right bundle branch block in older adults. Methods: Analytical cross-sectional study completed by 376 elderly patients treated at Almanzor Aguinaga Asenjo Hospital, Lambayeque-Peru. The dependent variable was the presence of right bundle branch block, and the independent variables were age, sex, history of hypertension, and diabetes. Prevalence ratios and 95 % confidence intervals were estimated. Results: Of 376 patients, the majority were male (55,9 %), the mean age was 75,6 years, 11,4 % had a history of hypertension and 9 % were diabetic; 41 % had a diagnosis of right bundle branch block. In simple regression, the frequency of right bundle branch block was 56 % (PR= 1,56; 95 % CI: 1,22-1,99), 65 % (PR=1,65; 95 % CI: 1,26 - 2,15) and 59 % (PR= 1,59; CI 95 %: 1,18 - 2,14) higher in women, hypertensive and diabetics; respectively. In the multiple regression; female sex (PR= 1,53; 95 % CI: 1,21 - 1,95), history of hypertension (PR= 1,55; 95 % CI: 1,21 - 2,00) and diabetes mellitus (PR= 1,49; 95 % CI: 1,12 - 2,00) were positively associated with right bundle branch block. The nested model selected the variables: female sex (PR= 1,54; 95 % CI: 1,21 - 1,96) and history of arterial hypertension (PR= 1,61; 95 % CI: 1,25 - 2,08). Conclusion: Female sex, history of arterial hypertension and diabetes mellitus were positively associated with presenting right bundle branch block in older adults.

Factors associated with producing a scientific publication during medical training: evidence from a cross-sectional study of 40 medical schools in Latin America.

Background: Scientific publication during medical training is key to promoting enduring cutting-edge knowledge. The promotion of science among medical students in Latin America is a multisectoral issue that is hampered by the lack of governmental knowledge to invest in national research, as well as by the lack of support from local universities. This study aims to determine the factors associated with the production of a scientific publication during medical training among Latin American medical students of local scientific societies. Methods: This is a secondary data analysis of a cross-sectional study conducted in 2016 that assessed the use of information and communication technologies (ICTs) among medical students from 40 local scientific societies of medical students affiliated with FELSOCEM. Teams from each local scientific society surveyed self-reported scientific publications and explored their association with socioeconomic, academic, and research training conditions. We applied nested models to identify the covariates associated with self-reported scientific publication, obtaining a parsimonious mixed-effects multilevel model grouped by medical scientific society. Results: Of 11,587 participants, the prevalence of scientific publications increased in 36% among medical students affiliated to a Scientific Society of Medical Students [parsimonious prevalence ratio (pPR)=1.36, 95%CI=1.16-1.59], 51% among medical students with advanced English proficiency [pPR=1.51, 95%CI=1.21 - 1.87], 85% among medical students who attended a scientific writing skills course [pPR=1.85, 95%CI=1.59-2.15], 81% among medical students who use Sci-Hub [pPR=1.81, 95%CI=1.50-2.20], and 108% among medical students who have access to a pirated academic account [pPR=2.08, 95%CI=1.83-2.36]. Conclusions: Producing a scientific publication among medical students is associated with being affiliated to a scientific society of medical students, English proficiency, training in scientific writing, use of Sci-Hub, and pirated academic accounts. The results will help clinical educators and medical programs improve resources for training students in high-quality research.