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Presentamos el caso de una paciente mujer de 31 años con antecedente de litiasis coraliforme bilateral. Ella inició la enfermedad un mes antes del ingreso con trombocitopenia y anemia hemolítica autoinmune. Fue diagnosticada con Síndrome de Evans, inicialmente tuvo marcadores de autoinmunidad negativos, finalmente presentó disnea progresiva y se le encontró 4 masas intracardiacas en aurícula derecha y marcadores positivos para síndrome antifosfolípido. A pesar de la anticoagulación y preparación para cirugía cardiaca, la paciente tuvo una muerte súbita.
We present the case of a 31-year-old female patient with a history of bilateral staghorn lithiasis, who started the disease one month before admission with thrombocytopenia and autoimmune hemolytic anemia. She was diagnosed with Evans Syndrome, initially she had negative autoimmunity markers, finally presented progressive dyspnea and 4 intracardiac masses were found in the right atrium and positive markers for antiphospholipid syndrome. Despite anticoagulation and preparation for cardiac surgery, she presented sudden death.
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INTRODUCTION: Approximately three billion people in Asia, Africa, and the Americas cook with biomass, cleaner cooking technologies with the potential to reduce household air pollution exposure. It is necessary to assess the adoption and long-term use of these stoves, measure perceived benefits among users, and use this information to provide feedback to programs that are implementing new cooking technologies. The aim of this study is to determine the level of adoption and impact of improved biomass cookstoves in the rural area of Lambayeque, Peru, in 2017. METHODS: A descriptive cross-sectional study was conducted. A total of 52 homes were surveyed in the districts of Pacora and Íllimo where improved biomass stoves were introduced between 2005 and 2013. A questionnaire for the assessment of adoption and impact indexes proposed by the Global Alliance for Clean Cookstoves was applied. The STROBE checklist was used. RESULTS: The mean number of years with the improved biomass cookstove was 9.1 (standard deviation: 2.9); 51.9% always used the improved stove, and 34.6% never used it due to destruction during the El Niño phenomenon in 2017. The median impact index was 5.62; 19.2% had a very good/good adoption. The median adoption index was 6.5; 25% had a very high/high impact. The use of the traditional or open fire biomass stove persisted in 61.5% of the houses. CONCLUSION: The adoption and impact of improved biomass cookstoves were acceptable, but traditional stove use persisted in more than half of the houses. Households used a mix of different stove technologies. Gas stoves were used more frequently for breakfast or dinner, while the traditional biomass stoves were used for larger lunchtime meals.
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Poluição do Ar em Ambientes Fechados , Utensílios Domésticos , Poluição do Ar em Ambientes Fechados/análise , Culinária , Estudos Transversais , Humanos , Peru , População RuralRESUMO
BACKGROUND: There are approximately 72,000 people living with HIV/AIDS (PLHIV) in Peru. Non-adherence to antiretroviral therapy (ART) is the most important factor for therapeutic failure and the development of resistance. Peru has achieved moderate progress in meeting the 90-90-90 targets, but only 60% of PLHIV receiving ART are virally suppressed. The purpose of this study was to understand ART adherence in the Peruvian context, including developing sociodemographic and clinical profiles, evaluating the clinical management strategies, and analyzing the relationships between the variables and adherence of PLHIV managed at a regional HIV clinic in Lambayeque Province (Northern Peru). METHODS: This was a cross-sectional study with 180 PLHIV adults, non-randomly but consecutively selected with self-reported ART compliance (78.2% of the eligible population). The PLHIV profile (PLHIV-Pro) and the Simplified Medication Adherence Questionnaire (SMAQ) were used to collect sociodemographic information, clinical variables, and data specific to ART adherence. Descriptive analysis of sociodemographic and clinical characteristics was performed. Bivariate analysis was performed with the Mann-Whitney test, Chi square test, and Yates correction. RESULTS: The 180 PLHIV sample included 78.9% men, 49.4% heterosexual, 45% with a detectable HIV-1 viral load less than 40 copies/ml, 58.3% not consistently adherent, and only 26.1% receiving Tenofovir + Lamivudine + Efavirenz. Risk factors significant for non-adherence included concurrent tuberculosis, discomfort with the ART regime, and previous pauses in ART. Multivariate analysis of nested models indicated having children is a protector factor for adherence. CONCLUSIONS: Self-reported adherence appeared to be low and the use of first-line therapy is not being prescribed homogeneously. Factors associated with nonadherence are both medical and behavioral, such as having tuberculosis, pausing ART, or experiencing discomfort with ART. The Peruvian government needs to update national technical standards, monitor medication availability, and provide education to health care professionals in alignment with evidence-based guidelines and international recommendations. Instruments to measure adherence need to be developed and evaluated for use in Latin America.
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Síndrome de Imunodeficiência Adquirida/tratamento farmacológico , Fármacos Anti-HIV/uso terapêutico , Infecções por HIV/tratamento farmacológico , Adesão à Medicação/estatística & dados numéricos , Adulto , Estudos Transversais , Feminino , HIV/efeitos dos fármacos , Humanos , Masculino , Peru , Fatores de Risco , Inquéritos e Questionários , Adulto JovemRESUMO
No disponible
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Humanos , Educação Médica/tendências , Medicina Baseada em Evidências/educação , Aprendizagem Baseada em Problemas/tendências , Gestão do ConhecimentoRESUMO
No disponible
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Humanos , Pesquisa Biomédica/normas , Relatório de Pesquisa/normas , Publicações Periódicas como Assunto/normas , TraduçãoRESUMO
No disponible
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Humanos , Aprendizagem Baseada em Problemas/métodos , Educação Médica/métodos , Avaliação Educacional , CurrículoRESUMO
Evaluar el nivel de conocimientos, actitudes y prácticas en relación al test de Papanicolaou en mujeres de 20 a 45 años. Diseño descriptivo, transversal; se entrevistaron 116 mujeres, 44,8 % tuvieron nivel alto de conocimientos, 47,4% actitud favorable y 38,8%, nivel de prácticas correcto. En las mujeres con actitud desfavorable con respecto al PAP se halló 5,6 veces más probabilidades de solamente haber concluido estudios en el colegio: OR: 5,6 (IC95%: 2,2-15,23 p< 0,05). El motivo más frecuente por el que no se habrían realizado el test, fue por falta de tiempo.(AU)
To evaluate the level of knowledge, attitudes and practices regarding the Papanicolau test in women from 20 to 45 years from Chiclayo during 2010. Descriptive, cross-sectional, prospective study; 116 women were interviewed. The mean age was 33,5 ± 7,6 years; 44,8% had a high level of knowledge, 47,4% had favorable attitudes and 38,8% good practices. The odds of the women with unfavorable attitude toward PAP was 5,6 of only having concluded the school studies: OR:5,6 (IC: 2,2-15,23 p < 0,05). Conclusions: The levels of knowledge, attitudes and practices are low in this population; an association was found between level of attitudes and educational level; the main reason why women have not performed PAP was lack of time.(AU)
