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2.
PLoS One ; 16(1): e0244920, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33417613

RESUMEN

BACKGROUND: The COVID-19 virus impacts human health and the world economy, causing in Peru, more than 800 thousand infected and a strong recession expressed in a drop of -12% in its economic growth rate for 2020. In this context, the objective of the study is to analyze the dynamics of the short-term behavior of economic activity, as well as to explain the causal relationships in a Pandemic context based on the basic number of spread (Re) of COVID-19 per day. METHODS: An Autoregressive Distributed Lags (ARDL) model was used. RESULTS: A negative and statistically significant impact of the COVID-19 shock was found on the level of economic activity and a long-term Cointegration relationship with an error correction model (CEM), with the expected sign and statistically significant at 1%. CONCLUSION: The Pandemic has behaved as a systemic shock of supply and aggregate demand at the macroeconomic level, which together have an impact on the recession or level of economic activity. The authors propose changing public health policy from an indiscriminate suppression strategy to a targeted, effective and intelligent mitigation strategy that minimizes the risk of human life costs and socioeconomic costs, in a context of uncertainty about the end of the Pandemic and complemented by economic, fiscal and monetary policies that mitigate the economic recession, considering the underlying structural characteristics of the Peruvian economy.

5.
PLoS One ; 15(12): e0244171, 2020.
Artículo en Inglés | MEDLINE | ID: mdl-33370364

RESUMEN

INTRODUCTION: Peru is among the top ten countries with the highest number of coronavirus disease 2019 (COVID-19) cases worldwide. The aim of the study was to describe the clinical features of hospitalized adult patients with COVID-19 and to determine the prognostic factors associated with in-hospital mortality. METHODS: We conducted a retrospective cohort study among adult patients with COVID-19 admitted to Hospital Cayetano Heredia; a tertiary care hospital in Lima, Peru. The primary outcome was in-hospital mortality. Multivariate Cox proportional hazards regression was used to identify factors independently associated with in-hospital mortality. RESULTS: A total of 369 patients (median age 59 years [IQR:49-68]; 241 (65.31%) male) were included. Most patients (68.56%) reported at least one comorbidity; more frequently: obesity (42.55%), diabetes mellitus (21.95%), and hypertension (21.68%). The median duration of symptoms prior to hospital admission was 7 days (IQR: 5-10). Reported in-hospital mortality was 49.59%. By multiple Cox regression, oxygen saturation (SaO2) values of less than 90% on admission correlated with mortality, presenting 1.86 (95%CI: 1.02-3.39), 4.44 (95%CI: 2.46-8.02) and 7.74 (95%CI: 4.54-13.19) times greater risk of death for SaO2 of 89-85%, 84-80% and <80%, respectively, when compared to patients with SaO2 >90%. Additionally, age >60 years was associated with 1.88 times greater mortality. CONCLUSIONS: Oxygen saturation below 90% on admission is a strong predictor of in-hospital mortality in patients with COVID-19. In settings with limited resources, efforts to reduce mortality in COVID-19 should focus on early identification of hypoxemia and timely access to hospital care.

10.
Artículo en Inglés | MEDLINE | ID: mdl-33325786

RESUMEN

Background: During the Health Emergency due to coronavirus disease 2019 (COVID-19) in Peru, elective surgeries were suspended and only emergency surgeries were allowed. Conservative management was considered as an alternative and laparoscopic surgery was indicated following safety recommendations. Surgically operated patients were at higher risk of becoming infected with COVID-19 due to hospital exposure, being more susceptible to complications. Methods: Retrospective cohort-type analytical study that includes patients who were admitted to a private center due to an emergency and who underwent laparoscopic gastrointestinal surgery during the National Health Emergency (group exposed to the COVID-19 pandemic) from March 11, 2020 to June 8, 2020 and were compared with those patients operated between March 11, 2019 and June 8, 2019 (group not exposed to the COVID-19 pandemic). Results: A total of 104 patients were identified, 59 patients operated during the COVID-19 pandemic. All were operated by laparoscopy, both groups with a similar degree of disease severity. There was no mortality or surgical reintervention. No surgeon at the institution was infected with the virus during the study period. Conclusions: The degree of severity of abdominal surgical pathologies in this time of pandemic has not increased compared with the previous year. Likewise, the laparoscopic approach to emergency surgery was safe and effective during the pandemic.

11.
Rev Peru Med Exp Salud Publica ; 37(3): 504-509, 2020 Dec 02.
Artículo en Español, Inglés | MEDLINE | ID: mdl-33295553

RESUMEN

The objective of the study was to describe the medical interns' (MI) perceptions about the internship suspension during the COVID-19 quarantine in Peru. A cross-sectional descriptive study was conducted by means of a virtual survey regarding the perception of the internship suspension, return conditions and academic activities during quarantine. A total of 353 MIs participated in the study; 54.9% agreed or totally agreed with returning to their hospital sites if biosecurity measures were guaranteed, more than 90% felt uncertain about the restart and end dates, and 85.6% participated in academic virtual classes. It is concluded that the intention to return to the hospital increases when biosecurity measures are guaranteed. Hospitals should guarantee these measures and ensure health coverage for the MIs, if their return to hospitals is intended.


Asunto(s)
Actitud del Personal de Salud , Internado y Residencia , Pandemias , Cuarentena , Adulto , Estudios Transversales , Femenino , Humanos , Internado y Residencia/estadística & datos numéricos , Masculino , Perú/epidemiología , Reinserción al Trabajo/estadística & datos numéricos , Encuestas y Cuestionarios/estadística & datos numéricos , Adulto Joven
12.
Rev Peru Med Exp Salud Publica ; 37(3): 541-546, 2020 Dec 02.
Artículo en Español | MEDLINE | ID: mdl-33295559

RESUMEN

Patients diagnosed with type 2 diabetes mellitus, who then become infected with SARS-CoV-2, are at greater risk of developing complications from COVID-19, which may even lead to death. Diabetes is a chronic condition that requires continuous contact with healthcare facilities; therefore, this type of patients should have regular access to medicines, tests and appointments with healthcare personnel. In Peru, care and treatment continuity have been affected since the national state of emergency due to COVID-19 began; because many healthcare facilities suspended outpatient consultations. The strategies presented in this study were developed by different Peruvian health providers in the pandemic context to ensure care continuity for people with diabetes. This article provides recommendations to strengthen primary healthcare, because it is the first level of healthcare contact for patients with diabetes.


Asunto(s)
/complicaciones , Continuidad de la Atención al Paciente/organización & administración , Prestación de Atención de Salud/organización & administración , Diabetes Mellitus Tipo 2/complicaciones , /epidemiología , Diabetes Mellitus Tipo 2/terapia , Urgencias Médicas/epidemiología , Accesibilidad a los Servicios de Salud/organización & administración , Humanos , Programas Nacionales de Salud , Pandemias , Perú/epidemiología , Telemedicina
13.
Rev Peru Med Exp Salud Publica ; 37(3): 559-565, 2020 Dec 02.
Artículo en Español | MEDLINE | ID: mdl-33295562

RESUMEN

During the COVID-19 pandemic, a new, severe and unusual condition called Multisystem Inflammatory Syndrome in children emerged, from which there is still much to learn. We report 8 children admitted to Instituto Nacional de Salud del Niño, in Lima, Perú. Their mean age was 5,1 years. Their clinical presentation included fever, acute gastrointestinal symptoms, ocular and mucocutaneous involvement. Four patients met criteria for classic Kawasaki Disease. All the patients had positive serology for SARS-CoV-2, abnormal complete blood counts and coagulation tests, and elevated inflammatory markers. Five had elevated liver enzymes and three had kidney involvement. Four patients met criteria for Macrophage Activation Syndrome. All of them received intravenous immune globulin, corticosteroids and aspirin. No coronary aneurysms were identified. Only one developed miocarditis, shock and was admitted to the Pediatric Intensive Care Unit. Most patients recovered successfully. Every child with fever, gastrointestinal and dermatological symptoms, associated with prior exposure to SARS-CoV-2, should be investigated for multi-systemic compromise.


Asunto(s)
/diagnóstico , Síndrome Mucocutáneo Linfonodular/diagnóstico , Síndrome de Respuesta Inflamatoria Sistémica/diagnóstico , Corticoesteroides/administración & dosificación , Anticuerpos Antivirales/análisis , /tratamiento farmacológico , Niño , Preescolar , Femenino , Hospitales Pediátricos , Humanos , Inmunoglobulina G/análisis , Inmunoglobulina M/análisis , Inmunoglobulinas Intravenosas/administración & dosificación , Factores Inmunológicos/administración & dosificación , Lactante , Síndrome de Activación Macrofágica/diagnóstico , Masculino , Perú , Síndrome de Respuesta Inflamatoria Sistémica/sangre , Síndrome de Respuesta Inflamatoria Sistémica/tratamiento farmacológico , Resultado del Tratamiento
17.
Injury ; 51(12): 2834-2839, 2020 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-33162012

RESUMEN

INTRODUCTION: By May 2020, Peru was the country with the third most COVID-19 cases in the Americas. The current study's overall aim was to examine the impact of the current COVID-19 outbreak on the number of non-COVID-related patient presentations to a major national emergency traumatology/orthopedics referral center in Latin America. METHODS: An observational study was performed at one of Peru's main tertiary trauma referral centers, during the current COVID-19 pandemic. Numbers of non-follow-up patients presenting to the traumatology/ orthopedics service were counted and compared between January through April 2019 and January through April 2020; and between the month immediately prior to the Peruvian government's implementation of national lock-down measures (Feb 16-Mar 15; Period 1) and the month immediately following (Mar 16-Apr 15; Period 2). The number of surgery service hospitalizations also was compared pre- versus post lockdown initiation (Period 1 vs. 2), as were patient characteristics and outcomes, like age, sex, discharge disposition, mortality, indications for hospital admission, and COVID-19 status. RESULT: Comparing 2019 and 2020, no appreciable differences were detected in the number of patients seen in either January or February. However, relative to March and April 2019, the numbers of patients seen in March and April 2020 (the two months after the first Peruvian case of COVID-19 was detected) were reduced by 55.8 and 88.6%, respectively. Comparing the months immediately pre and post lockdown, the number of service patients declined by 79.9% in April, while the number of hospitalizations declined by 30.9%. The number of admissions for various surgical indications either remained stable or declined in parallel with the overall decline in admissions for all indications except for osteoporotic hip fractures and diabetic foot ulcers (both of which increased proportional to the overall number of admissions) and for hand and foot fractures, both of which decreased. CONCLUSION: At our hospital, not all indications for traumatology/orthopedics service utilization declined despite the national government's directive to reduce non-COVID-related consultations and admissions. Some disorders presented with even greater frequency, which must be considered when developing contingencies for the reallocation of healthcare resources during a pandemic.


Asunto(s)
/epidemiología , Servicio de Urgencia en Hospital/estadística & datos numéricos , Centros de Atención Terciaria/estadística & datos numéricos , Centros Traumatológicos/estadística & datos numéricos , Heridas y Traumatismos/epidemiología , Anciano , Anciano de 80 o más Años , /prevención & control , Comorbilidad , Femenino , Mortalidad Hospitalaria , Humanos , Tiempo de Internación/estadística & datos numéricos , Masculino , Persona de Mediana Edad , Pandemias/prevención & control , Aceptación de la Atención de Salud/estadística & datos numéricos , Admisión del Paciente/estadística & datos numéricos , Perú/epidemiología , Derivación y Consulta/estadística & datos numéricos , Heridas y Traumatismos/diagnóstico , Heridas y Traumatismos/terapia
18.
Crit Rev Oncol Hematol ; 157: 103129, 2020 Oct 22.
Artículo en Inglés | MEDLINE | ID: mdl-33227573

RESUMEN

COVID-19 pandemic is the more challenging public health emergency of the century, producing the collapse of health systems and unprecedented levels of morbidity and mortality around the world, especially in low resource settings. Patients with chronic diseases are the most affected, not only due to the high susceptibility to SARS-CoV-2 infection but also due to the decrease in opportunities for timely care. In this dark landscape, telemedicine, before limited to very specific scenarios, has become one of our main tools to manage cancer patients, particularly in Latin America where COVID-19 has had a strong impact on the public health. Telemedicine can provide rapid access to specialized cancer care in a scenario complicated, reducing the exposure of patients and healthcare personnel to the SARS-CoV-2. In this review, we would like to share our experience and our workflow using telemedicine at Oncosalud-AUNA, a private clinic in Peru.

19.
Prev Med ; 143: 106331, 2020 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-33232687

RESUMEN

Although lockdown measures to stop COVID-19 have direct effects on disease transmission, their impact on violent and accidental deaths remains unknown. Our study aims to assess the early impact of COVID-19 lockdown on violent and accidental deaths in Peru. Based on data from the Peruvian National Death Information System, an interrupted time series analysis was performed to assess the immediate impact and change in the trend of COVID-19 lockdown on external causes of death including homicide, suicide, and traffic accidents. The analysis was stratified by sex and the time unit was every 15 days. All forms of deaths examined presented a sudden drop after the lockdown. The biggest drop was in deaths related to traffic accidents, with a reduction of 12.22 deaths per million men per month (95% CI: -14.45, -9.98) and 3.55 deaths per million women per month (95% CI:-4.81, -2.30). Homicide and suicide presented similar level drop in women, while the homicide reduction was 2.5 the size of the suicide reduction in men. The slope in homicide in men during the lock-down period increased by 6.66 deaths per million men per year (95% CI:3.18, 10.15). External deaths presented a sudden drop after the lockdown was implemented and an increase in homicide in men was observed. Falls in mobility have a natural impact on traffic accidents, however, the patterns for suicide and homicide are less intuitive and reveal important characteristics of these events, although we expect all of these changes to be transient.

20.
Lima; Perú. Ministerio de Salud; 20201100. 32 p. tab.
Monografía en Español | LILACS, MINSAPERÚ | ID: biblio-1087618

RESUMEN

El documento contiene los lineamientos y procedimientos para la vigilancia epidemiológica del COVID-19 en el país. Esta Directiva, deroga a la R.M. Nº 145-2020-MINSA.


Asunto(s)
Control de Enfermedades Transmisibles , Guías como Asunto , Infecciones por Coronavirus , Coronavirus , Servicios de Vigilancia Epidemiológica , Monitoreo Epidemiológico
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