Nephrology: is a medical specialty unattractive to Peruvian doctors?

Although the National Committee of Medical Residency (CONAREME) has increased the number of nephrology residency positions in Peru, the increase has not been proportional to the number of applicants. This is worrisome in an environment lacking of nephrologists, like our country. The Peruvian Society of Nephrology (SPN) should take the measures to make this specialty more attractive to Peruvian physicians.
Source: Jornal Brasileiro de Nefrologia
URL: http://hdl.handle.net/10757/554221

Factors associated with poor sleep quality among patients with chronic kidney diseases in hemodialysis

Introduction and objectives Sleep disorders are one of the most common comorbidities among patients on hemodialysis. The aims of this study were to determine the prevalence of poor sleep quality as well as to establish potential factors associated with poor sleep quality. Materials and methods A cross-sectional study was performed enrolling patients with chronic kidney disease on hemodialysis. The outcome was sleep quality evaluated using the Pittsburgh Scale, whereas the exposure variables were time on hemodialysis, history of type-2 diabetes and hypertension, depressive symptoms, anemia, and uremia. We used Poisson regression model to determine the association of interest, reporting prevalence ratios (PR) and 95% confidence intervals (95%CI). Results A total of 450 patients were enrolled, 259 (57.5%) were male, aged from 18 to 97 years. The prevalence of poor sleep quality was 79.3% (95%CI: 75.6%–83.1%). Poor sleep quality was associated with depressive symptoms (PR = 1.28; 95%CI: 1.17-1.39), anemia (PR = 1.18; 95%CI: 1.04-1.34) and uremia (PR = 1.26; 95%CI: 1.17-1.36) after controlling for potential confounders. Conclusions The presence of depressive symptoms, anemia and uremia were positively associated with poor sleep quality among patients with chronic kidney disease on hemodialysis. A great proportion of this population had poor sleep quality. Strategies are needed to improve sleep quality in these patients.
Source: Elsevier:
URL: http://hdl.handle.net/10757/554084

Psychiatric symptoms and insulinoma: a case report

Introduction
Insulinomas are pancreatic endocrine neoplasms with a low incidence between 1-4 cases per million per year. Case description: A female 49 years-old with neurological and psychiatric symptoms were treated for two years as a psychiatric patient. Presented a glucose value, which reflects hypoglycemia. The patient was operated with resolution of symptoms. Conclusion: Assess all patients with psychiatric symptoms and perform a complete medical history and laboratory findings, being the most opportune glucose
Source: Sociedad de Neurología, Psiquiatría y Neurocirugía de Chile (SONEPSYN
URL: http://hdl.handle.net/10757/311275

Contrast profiles of bullying in Peru and Spain

Dear editor: We read with greatinterestthe article Bullying among schoolchildren: differences between victims and aggressors, recently published in Gaceta Sanitaria.1 Motivated by this study, we would like to share information about the characteristics of victims and aggressors of bullying in Peru after an extensive literature search about this underexplored topic in our country and attempt some comparisons versus Spain as well as some concluding remarks and recomendations. Bullying in Peru, as very likely in Spain, is a hidden and yet latent phenomenon. Moreover, it varies across regions in our country and profiles might be different than what is found in Spain. In a study conducted in an urban Lima school in 2007, victims usually had fewer friends, spent more time alone at recess and exhibited decreased self-confidence than non-victims.2 Similarly, another study conducted in in 2009 found that adolescents with any physical defects are more prone to being bullied, being excluded by aggressors and experience discriminative behaviors that cause impaired social image of the victim and generate rivalries with peers.3 In Peruvian rural areas adolescent victims tend to be picked on by peers, be very quiet, fearful and considered small and weak and not to respond to attacks.2–4 On the other hand, the aggressors’ profile also differs from the ones in Spain. In a study conducted in 2009,3 they selfconsidered big and strong, use foul language frequently and were happy when insulting or beating their peers. They also tend to be surrounded by groups that support them, and have a history of having been expelled from other schools.4 Aggressors have no overall self-esteem issues because they are usually physically stronger, and are considered “popular,” but they had a lower score on home self-esteem because they come from families with difficulties.2 Moreover, another study noted the presence of gangs or gang friends in school environment as risk factors for bullying.3 A summary of the main characteristics of victims and aggressors in Peruvian studies is presented in Table 1. In conclusion, bullying is a complex social phenomenon that changes across environments, cultures and countries and even within a country as exhibited in Peruvian studies. All these factors might potentially shape different profiles for both victims and aggressors and this point out the need to establish prevention programs tailored to each specific context as well as to the specific needs of the involved subjects.
Source: Sociedad Española de Salud Pública y Administración Sanitaria
URL: http://hdl.handle.net/10757/311272

Online buying and selling of thesis: An ethical problem to control

Source: Rev Peru Med Exp Salud Publica
URL: http://hdl.handle.net/10757/311236