Factors associated with in hospital deaths in a hemodialysis population in Peru

Objectives. To determine the factors associated with mortality during the first hospitalization of patients admitted to a hemodialysis unit. Materials and methods. Observational and retrospective study of patients admitted to “Dos de Mayo” National Hospital between January 2012 and December 2013. For the survival analysis we used the Kaplan-Meier method. A multivariate logistic regression was performed to evaluate the factors associated with hospital mortality. Results. 216 patients with a mean age of 56.9 ± 15.5 years were studied. 24% of patients (n = 51) died during their hospital stay. The mortality rate was 9.3 deaths/100 person-weeks (95% CI: 7.0 to 12.3). We found a tendency of less risk of death in patients with between 1 and 6 months from chronic kidney disease diagnosis (OR 0.84, 95% CI: 0.32 to 2.26) and in those with more than six months from chronic kidney disease diagnosis compared with those who had less than a month from chronic kidney disease diagnosis (OR 0.55, 95% CI: 0.19 to 1.57). Previous care by a nephrologist was not associated with differences in lower mortality (OR 1.14, 95% CI: 0.39 to 3.31). Conclusions. There is poor prior care among hemodialysis patients that form part of an inadequate health care structure and this is associated with high inhospital mortality.

Author(s): Herrera Añazco, Percy; Benítes Zapata, Vicente A.; Hernandez, Adrián V.
Source: Revista Peruana de Medicina Experimental y Salud Pública (Rev Peru Med Exp Salud Publica (Rev Peru Med Exp Salud Publica)

URL: http://hdl.handle.net/10757/582532

Detection of Bordetella pertussis using a PCR test in infants younger 3 than one year old hospitalized with whooping cough in five 4 Peruvian hospitals

Objectives To report the incidence, epidemiology, and clinical features of Bordetella pertussis in Peruvian infants under 1 year old. Patients and methods A prospective cross-sectional study was conducted in five hospitals in Peru from January 2010 to July 2012. A total of 392 infants under 1 year old were admitted with a clinical diagnosis of whooping cough and tested for B. pertussis by PCR. Results The pertussis toxin and IS481 genes were detected in 39.54% (155/392) of the cases. Infants aged less than 3 months were the most affected, with a prevalence of 73.55% (114/155). The most common household contact was the mother, identified in 20% (31/155) of cases. Paroxysm of coughing (89.03%, 138/155), cyanosis (68.39%, 106/155), respiratory distress (67.09%, 104/155), and breastfeeding difficulties (39.35%, 61/155) were the most frequent symptoms reported. Conclusion An increase in pertussis cases has been reported in recent years in Peru, despite national immunization efforts. Surveillance with PCR for B. pertussis is essential, especially in infants less than 1 year old, in whom a higher rate of disease-related complications and higher mortality have been reported.

Author(s): Castillo, María Esther; Bada, Carlos; Del Aguila, Olguita; Petrozzi Helasvuo, Verónica; Casabona Ore, Verónica;Reyes, Isabel; Del Valle Mendoza, Juana Mercedes ( 0000-0002-6011-5040 ) 
Source: International Society for Infectious Diseases (Int J Infect Dis)

URL: http://hdl.handle.net/10757/582607

Producción científica de los decanos de las facultades de medicina en Perú

Señor editor: Se ha cuestionado si las instituciones médicas regulatorias apuestan por la investigación cientí- fica en Perú,1 pues a ésta se le subestima en procesos de calificación como el Comité Nacional de Residentado Médico y el Sistema de Certificación y Recertificación del Médico Cirujano y Médicos Especialistas,1 o debido a la pobre producción científica de los miembros de la Academia Nacional de Investigadores Médicos.

Author(s): Valenzuela Rodríguez, Germán; Herrera Añazco, Percy; Hernández, Adrián V.
Source: Salud Pública de México (Salud pública Méx)
URL: http://hdl.handle.net/10757/582609

La depresión dentro de la atención primaria, ¿dónde estamos en este tema?

Señor editor: En los últimos años ha aumentado la conciencia sobre la importancia de la salud mental, lo que la convierte en prioridad para nuestros servicios de salud.1 Con cerca de 350 millones de afectados, la depresión es la décima causa de discapacidad global a nivel mundial (%DALY: 2.7) y la segunda en América (%DALY: 4.1).2 Además, tiene una fuerte asociación con la evolución de enfermedades crónicas3 como diabetes4 e hipertensión,5 y con enfermedades infecciosas crónicas como VIH6 y tuberculosis.7 Esto hace necesario incluir el manejo de la depresión dentro del plan de control de estos padecimientos.

Autores: Arroyo Garate, Rodrigo; Catter, Andrés; Gismondi Altamirano, Giancarlo
Fuente: Salud Pública de México (Salud pública Méx)
URL: http://hdl.handle.net/10757/582608

Risk factors of small for gestational age neonates in a hospital of Lima, Peru

Objectives. Identify risk factors for at-term small for gestational age newborns. Materials and methods. Retrospective cohort study using data from the Maternal Perinatal Information System of the Maria Auxiliadora Hospital of Lima, from the period 2000-2010. Maternal age, parity, education level, marital status, pregestational body mass index, number of prenatal care visits, presence of conditions such as preeclampsia, eclampsia, urinary tract infection and gestational diabetes as risk factors in small for gestational age newborns were evaluated. The weight for gestational age was calculated based on Peruvian percentiles. Crude relative risk (RR) and adjusted (ARR) were calculated with confidence intervals of 95% using log-binomial generalized linear models. Results. 64,670 pregnant women were included. The incidence for small for gestational age was 7.2%. Preeclampsia (ARR 2.0, 95% CI: 1.86 to 2.15), eclampsia (ARR 3.22, 95% CI: 2.38 to 4.35), low maternal weight (ARR 1.38; 95% CI: 1.23 to 1.54), nulliparity (ARR 1.32, 95% CI: 1.23 to 1.42), age ≥35 years (ARR 1.16, 95% CI: 1.04 -1.29), having prenatal care visits from 0 to 2 (ARR 1.43, 95% CI: 1.32 to 1.55) and 3 to 5 (ARR 1.22, 95% CI: 1.14 to 1.32) were risk factors for small for gestational age. Conclusions. It is necessary to identify pregnant women with risk factors such as those found to decrease the condition of small for gestational age. Actions should emphasize modifiable factors, such as the frequency of prenatal care visits.

Author(s): Tejeda Mariaca, J. Eduardo; Pizango Mallqui, Orion; Alburquerque Duglio, Miguel; Mayta Tristán, Percy
Source: Revista Peruana de Medicina Experimental y Salud Pública (Rev Peru Med Exp Salud Publica)

URL:  http://hdl.handle.net/10757/582632