[Knowledge, practices and attitudes toward volunteer work in an influenza pandemic: cross-sectional study with Peruvian medical students]. / Conocimientos, prácticas y actitudes hacia el voluntariado ante una influenza pandémica: estudio transversal con estudiantes de medicina en Perú.

INTRODUCTION: Reductions in health personnel during disasters or epidemics such as an influenza pandemic may need to include volunteer students. OBJECTIVE: The aim of this article is to determine knowledge and practices about pandemic influenza and the attitudes towards volunteer work in Peruvian medical students. METHODS: We performed a cross-sectional analytic study by simple sampling using a survey regarding “"knowledge and practices"” about pandemic influenza and the attitudes to volunteer work. RESULTS: From the group of 865 students who were surveyed, 848 accepted to participate in the investigation (54% were male and their mean age was 22.1 ± 3.0). Ninety-seven percent correctly identified the spread routes of influenza and 81% knew its treatment. Regarding preventive measures, covering the mouth when coughing/sneezing and hand-washing were the most commonly recognized options (95% y 92%, respectively), and vaccination was the less recognized one (54%). The most common practice, readily acknowledged as preventive, was covering when coughing/sneezing (86%). Regarding volunteer works, students answered that it is a moral/ethical/professional obligation (77%); that a contingency university service needs to be established (88%), that it does not have to substitute for the lack of workers (49%), and that its role should be related to hospital work (83%). Coming from a public university was more associated to the concept that volunteer work was a moral obligation and that the student should be punished if he/she refuses to be a volunteer, whereas being from a private university was more related to a history of been involved in volunteering programs. CONCLUSIONS: In general, medical students have good knowledge and practices toward influenza. There is a good disposition to volunteer their work and skills, recognizing it as a moral/ethical/professional obligation.

INTRODUCCIÓN : La reducción crítica en el personal de salud ante situaciones de desastre o epidemia como una pandemia de influenza podría requerir la necesidad de incluir estudiantes voluntarios. OBJETIVO: El objetivo del artículo es determinar los conocimientos y prácticas sobre influenza pandémica y la actitud hacia el voluntariado en estudiantes de medicina peruanos. MÉTODOS: Estudio transversal analítico por muestreo simple utilizando una encuesta. RESULTADOS: De los 865 estudiantes, 848 aceptaron participar en el estudio (54% varones, edad promedio 22,1 ± 3,03). El 97% identificó de manera correcta las vías de propagación de la influenza y el 81% conocía su tratamiento. Sobre medidas preventivas correctas, cubrirse al toser o estornudar y lavado de manos fueron las respuestas mejores reconocidas (95% y 92%, respectivamente) y la vacunación fue la menor (54%). La práctica más frecuentemente realizada fue cubrirse al toser o estornudar (86%). Al respecto del voluntariado los participantes respondieron que es un deber moral/ético/profesional (77%), que se debe instituir un servicio universitario de contingencia (88%), que no debe suplir la falencia de trabajadores (49%) y que debe radicar en atención médica hospitalaria (83%). El pertenecer a universidades estatales estuvo más asociado a pensar que el voluntariado es una obligación moral y que el estudiante debe ser castigado en caso se niegue a ser voluntario, mientras que el pertenecer a universidades particulares estuvo más asociado con el antecedente de haber participado en un programa de voluntariado. CONCLUSIONES: En general, los estudiantes poseen un buen nivel de conocimientos y prácticas sobre influenza. Hay una buena disposición hacia el voluntariado reconociéndolo como una obligación moral/ética/profesional.

Validation of the salivary urea test as a method to diagnose chronic kidney disease.

BACKGROUND: Serum urea correlates very well to salivary urea, which can be used as a low-cost, easily accessible and noninvasive diagnostic method for screening patients in early stages of kidney disease, especially in developing countries where resources are limited, giving the possibility of establishing secondary prevention programs later. METHODS: One hundred and one people were enrolled: 11 with creatinine clearance (CrCl) less than 10 ml/min per 1.73 m(2); 10 with CrCl of 11-20 ml/min per 1.73 m(2); 12 with CrCl of 21-50 ml/min per 1.73 m(2); 26 with CrCl of 51-80 ml/min per 1.73 m(2) and 42 with CrCl of 81-170 ml/min per 1.73 m(2), to analyze salivary urea test accuracy through construction of a receiver operating characteristic curve. RESULTS: Salivary urea cutoff point of 20 mg/dL and a CrCl of 80 ml/min per 1.73 m(2) showed sensitivity (S) of 0.98, specificity (SP) of 0.29, pretest probability (PPT) of 0.58, positive predictive value (PPV) of 0.66, negative predictive value (NPV) of 0.92, posttest positive probability (PTPP) of 0.66 and posttest negative probability (PTNP) of 0.09. A cutoff point of 40 mg/dL and a CrCl of 80 ml/min per 1.73 m(2) showed S=0.80, SP=0.71, PPT=0.58, PPV=0.80, NPV=0.71, PTPP=0.79 and PTNP=0.28. A cutoff point of 100 mg/dL and a CrCl of 80 ml/min per 1.73 m(2) showed S=0.22, SP=1, PPT=0.58, PPV=1, NPV=0.48, PTPP=1 and PTNP=0.52. Receiver operating characteristic curve analysis showed that the best cutoff point for salivary urea was 40 mg/dL. CONCLUSION: The salivary urea test has a great capacity to discriminate patients with chronic kidney disease from healthy people, and it was shown that the best cutoff point is 40 mg/dL.