Differences in survival between patients with systemic lupus erythematosus from a public and a private center

Sr. Editor:
Hemos leído con atención el artículo publicado por el servicio de Reumatología del Hospital José María Cullen de Santa Fe, Argentina1. Nos parece relevante la comparación de la evolución del lupus eritematoso sistémico (LES) en un centro privado y uno público, ya que el desenlace de esta enfermedad se podría ver afectado por diversos factores que involucran estar en cualquiera de los centros mencionados, como el tratamiento farmacológico brindado y las características demográficas de la persona que acude a un centro público y uno privado. Estos factores influyen en la calidad de vida y el grado de actividad de la enfermedad en el paciente2. Sin embargo, el estudio presentado tiene algunas limitaciones que ponen en tela de juicio los resultados reportados. En primer lugar, no se define el momento en que los autores inician el seguimiento de enfermedad de los pacientes. Esto podría sesgar el estudio ya que el pronóstico de supervivencia de LES varía de acuerdo con varios factores, como el grado de actividad de la enfermedad en la que se encuentra la persona, la edad y las comorbilidades en el momento de diagnóstico, entre otras3. Segundo, no se determina si los pacientes son usuarios exclusivos de uno de los sistemas de salud (público o privado), si tienen ambos sistemas de salud o si durante los anos ˜ de seguimiento cambiaron de un sistema a otro. Esto generaría que los pacientes reciban más de un tratamiento simultáneamente o tratamientos distintos por cada centro en diversos periodos
Authors: Godoy Carrillo, Maria Claudia; Meneses Saco, Alejandra
Source: Reumatología Clinica (Reumatol Clin)
URL:  http://hdl.handle.net/10757/337884

Low adherence to hemodialysis regime in patients with chronic renal disease in a Peruvian Ministry of Health reference hospital

Objectives: To describe the frequency and perceived causes of non-adherence to dialysis in a Peruvian national reference public hospital. Design: Descriptive study. Setting: Nephrology department, Hospital Nacional 2 de Mayo, Lima, Peru. Participants: Patients with more than one year on dialysis. Interventions: The number of absences to appointed sessions was determined and a validated questionnaire was used to describe perceptions regarding the causes of absences. Main outcomes measures: Low adherence to dialysis defined as patients with more than one absence per month or more than 12 absences between July 2012 and July 2013. Results: The study included 54 patients, of which 27 were male. Average age was 57 ± 16.4 years and average time on dialysis was 40.6 ± 11.5 months. Only 7 patients had higher education. There were 504 absences (5.45%). The second day of the weekly schedule was the day with more absences (292), followed by the third day (145). Overall 13 patients showed low adherence. Main causes of absence reported included a remote residence (6/13), feeling good (6/13), and insufficient financial resources to cover transportation costs (5/13). Conclusions: A quarter of patients had low adherence, and main factors were distance to health facility and wellbeing self-perception.
Authors: Herrera Añazco, Percy; Palacios Guillen, Melissa; Mezones Holguin, Edward; Hernandez, Adrian V.; Chipayo Gonzales, David
Source:  Anales de la Facultad de Medicina

URL:  http://hdl.handle.net/10757/336754

Validation of a scale to assess contamination at home, study in rural Peru

Objectives: To validate a scale to assess contamination of food at home and measure the validity and reliability. Methods: mothers or caregivers with children under 5 years were surveyed in San Juan de Lurigancho in Lima Peru. The scale was previously subject to a rating of expert judges. Factor analysis with principal components was performed; the internal consistency was measured with Kuder-Richardson Formula 20 (KR-20) and the validity of the test with the coefficient Kaiser-Meyer-Olkin (KMO) and the sphericity test Barlet. Results: The sample was 194 caregivers. Three components (Practices cleaning, storage practices and pollution of the child) with a total of 10 items were identified. The item Cleaning Practices had a KR-20 = 0.722 storage practices and food contamination 0.518 and 0.5 respectively. The validity of the test was KMO = 0.549 and 591,678. Barlet test, df = 136, (p <0.05). Conclusions: This scale can contribute to the planning of interventions in the aspect of pollution in the home and thus reduce episodes of infections in children.
Authors: Lozada Urbano, Michelle; Rivera, Roger; Miranda, Doris; Gallegos Vergara, Clara; Reyes Villegas, María Ysabel; Xirinachs Salazar, Yanira
Source: Arch Med

URL:  http://hdl.handle.net/10757/336526

Mandatory requirement of social health service in Peru: Discriminatory and unconstitutional

The rural and urban-edge health service (SERUMS) is an activity that only health professionals perform for the Peruvian government, as it is a mandatory requirement to qualify for a second specialty or to work in public hospitals and public health care facilities, and obtain government scholarships for future training. The few legal changes in the rules of this social program and the focus of “service” restricted to health professionals lead to a perception of this policy as discriminatory and unconstitutional because it violates the right to education and work. There is no scientific evidence that supports the usefulness and effectiveness of this program in terms of quality of service and health indicator improvement, as well as in adequate distribution and retention of health professionals. We suggest to abolish the compulsory requirement and to reformulate a political strategy to help attract and retain health professionals in vulnerable areas of Peru.
Authors: Mayta Tristán, Percy; Poterico, Julio A.; Galán Rodas, Edén; Raa Ortiz, Daniel
Source: Rev Peru Med Exp Salud Publica
URL:  http://hdl.handle.net/10757/336532

Use of information sources by recently graduated physicians of Lima

 In order to determine the use of information sources by recently graduated physicians of Lima, Peru in 2011, a survey was conducted among graduated physicians at seven universities. They were asked about the use of search engines in the health area during their year of medical internship [last year of medical school]. Regular use was defined as the source being used once a week or daily. For 490 respondents, regularly used information sources were SciELO, accessed by 173 (36.4%); PubMed 165 (34.4%); HINARI 117 (25.5%); UpToDate 98 (22.3%); Cochrane Library 94 (20.6%); LILACS 91 (19.8%); a hospital institutional library 70 (15.0%); LIPECS 39 (8.7%); and Peru BVS 42 (9.3%). Only a minority regularly accessed information sources related to health. It is necessary to improve capacity in the efficient use of various resources of scientific information in a continuous way and that reaches students and health professionals.
Authors: R. Mejia, Christian; Caceres, Onice J.; Vera, Claudia A.; Nizama Vía, Ayar; Curioso, Walter H.; Mayta Tristán, Percy
Source: Rev Peru Med Exp Salud Publica

URL:  http://hdl.handle.net/10757/336475