ABSTRACT Objective: To assess glycemic control in patients with diabetes mellitus (DM) seen in live consultation or remote consultation, and to identify factors associated with variations in glycated hemoglobin (HbA1c) values. Materials and methods: We did a retrospective cohort study that included patients >18 years old who were seen in live consultation or remote consultation because of DM in Alberto Sabogal-Sologuren National Hospital, during June 2021. Clinical data from electronic clinical records were obtained, including baseline and at 11-month follow-up HbA1c values. We used Poisson regression with robust variance for calculating relative risk (RR) and 95% confidence intervals (CI), for identifying factors associated with ≥0.5 HbA1c variations during follow-up. Results: Four-hundred and sixteen patients were included, their mean age was 62 years, 57.2% were female, and 68.5% had remote consultation. The percentage of patients with HbA1C <7% increased from 21,7 to 27,4% during follow-up, while in those with HbA1C ≥10%, there was a reduction, from 38,2 to 19,1%. Amongst patients with baseline HbA1c ≥7%, having baseline HbA1c ≥10% was associated with ≥0,5% reduction in HbA1c values (adjusted RR: 2,97; 95% CI: 1,61-5,50). The consultation modality (live or remote) was not associated with significant variations in HbA1c levels. Conclusions: One fifth of patients had optimum glycemic control at baseline, and this rate increased during follow-up. Those who had baseline HbA1C ≥10% had greater frequency in HbA1c level reduction, although the consultation modality (live or remote) was not associated with variations in HbA1c levels.

RESUMEN Objetivo: evaluar el control glucémico entre pacientes con diabetes mellitus (DM) atendidos en consulta presencial y por teleconsulta, e identificar factores asociados a variaciones de hemoglobina glicosilada (HbA1c). Materiales y métodos: Se realizó un estudio de cohortes retrospectivo, que incluyó a pacientes > 18 años evaluados en consulta presencial o teleconsulta por DM en el Hospital Nacional Alberto Sabogal Sologuren, durante junio 2021. Se recolectaron datos clínicos de las historias clínica electrónicas, entre ellos los niveles de HbA1c inicial y al seguimiento a 11 meses. Utilizamos regresiones de Poisson con varianza robusta para calcular riesgos relativos (RR) y sus intervalos de confianza del 95% (IC 95%), con el fin de identificar factores asociados a variaciones de HbA1C ≥ 0,5 durante el seguimiento. Resultados: se incluyeron 416 pacientes, la mediana de edad fue de 62 años, el 57,2% eran mujeres y el 68,5% se atendieron por teleconsulta. El porcentaje de pacientes con HbA1C < 7% aumentó del 21,7 al 27,4% durante el seguimiento, mientras que aquellos con HbA1C ≥ 10% disminuyó del 38,2 al 19,1%. Entre los pacientes con HbA1C basal ≥ 7%, tener una HbA1C basal ≥ 10% se asoció con una disminución de la HbA1C ≥ 0,5% (RR ajustado: 2,97; IC 95 %: 1,61-5,50). El tipo de consulta (presencial o teleconsulta) no se asoció con variaciones significativas de HbA1C. Conclusiones: la quinta parte de los pacientes tuvo un control glucémico óptimo al inicio, cifra que aumentó en el seguimiento. Aquellos con HbA1C basal ≥ 10% tuvieron mayor incidencia de reducción de HbA1C, aunque el tipo de consulta (presencial o teleconsulta) no se asoció con variación en el nivel de HbA1C.

Resumo Histórico: Pacientes com DRC apresentam maior risco de doença grave e mortalidade por COVID-19 do que a população geral. Objetivo: Comparar taxas de hospitalização e mortalidade durante a pandemia entre pacientes em hemodiálise crônica (HD) e a população geral em Lima (Peru). Métodos: Esta coorte retrospectiva incluiu avaliação do banco de dados de pacientes em HD crônica dos prestadores de serviços de saúde das redes de benefícios do seguro social de saúde de Lima e Callao, entre 2019–2021. Obteve-se taxas de hospitalização e mortalidade para cada 1.000 indivíduos, e foram calculadas variações nas porcentagens de casos de COVID-19 e óbitos. Estas taxas foram comparadas com os dados da população geral e padronizadas por idade e sexo. Resultados: Uma média de 3.937 pacientes em HD crônica foram avaliados mensalmente. Destes, 4,8% tinham COVID-19, 64,97% eram casos leves. As taxas de hospitalização por 1.000 pacientes foram 19,5; 29,28; e 36,7 em 2019, 2020, e 2021, respectivamente. As taxas de mortalidade por 1.000 pacientes foram 5,9; 9,74 e 11,49 em 2019, 2020, e 2021, respectivamente. Quando comparados à população geral padronizada, os picos das taxas coincidiram com os platôs das ondas da pandemia. A taxa de hospitalização para COVID-19 foi 12 vezes maior em pacientes em HD do que na população geral e a taxa de mortalidade por COVID-19 foi duas vezes maior. Conclusão: Pacientes em HD apresentaram taxas de hospitalização e mortalidade padronizada mais elevadas do que a população geral. Os picos das hospitalizações e mortalidade coincidiram com os platôs da primeira e segunda ondas da pandemia. Histórico COVID19 COVID 19 COVID-1 Objetivo (HD Peru. Peru . (Peru) Métodos Callao 20192021 2019 2021 2019–2021 Obtevese Obteve se 1000 1 000 1.00 indivíduos óbitos sexo Resultados 3937 3 937 3.93 mensalmente Destes 48 4 8 4,8 COVID19, 19, 6497 64 97 64,97 leves 19,5 195 5 29,28 2928 29 28 367 36 7 36, 2020 respectivamente 5,9 59 9 974 74 9,7 1149 11 49 11,4 Conclusão COVID1 COVID- (Peru 2019202 201 202 2019–202 100 00 1.0 393 93 3.9 4, 649 6 64,9 29,2 292 2 5, 9, 114 11, 201920 20 2019–20 10 0 1. 39 3. 64, 29, 20192 2019–2 2019–

ABSTRACT Background: Patients with chronic kidney disease have a higher risk of severe disease and mortality from COVID-19 than the general population. Objective: To compare hospitalization and mortality rates during the pandemic among chronic hemodialysis (HD) patients and the general population in Lima (Peru). Methods: This retrospective cohort included an assessment of the database of chronic HD patients of the health service providers of the social health insurance benefit networks of Lima and Callao between 2019 and 2021. Hospitalization and mortality rates were obtained for every 1,000 individuals, and variations in the percentages of COVID-19 cases and deaths were calculated. These rates were compared with those of the general population data and standardized by age and sex. Results: An average of 3,937 chronic HD patients were evaluated each month. Of these, 4.8% had COVID-19 and 64.97% were mild cases. The hospitalization rates per 1,000 patients were 19.5, 29.28, and 36.7 in 2019, 2020, and 2021, respectively. The mortality rates per 1,000 patients were 5.9, 9.74, and 11.49 in 2019, 2020, and 2021, respectively. When compared to the standardized general population, the peaks of both rates coincided with the plateaus of the waves during the pandemic. The hospitalization rate for COVID-19 was 12 times higher in HD patients than in the general population, and the mortality rate for COVID-19 was twice as high. Conclusion: HD patients had higher hospitalization and standardized mortality rates than the general population. Peaks in hospitalizations and mortality coincided with the plateaus of the first and second waves of the pandemic. Background COVID19 COVID 19 COVID-1 Objective (HD Peru. Peru . (Peru) Methods 201 2021 1000 1 000 1,00 individuals calculated sex Results 3937 3 937 3,93 month these 48 4 8 4.8 6497 64 97 64.97 195 5 19.5 2928 29 28 29.28 367 36 7 36. 2020 respectively 59 9 5.9 974 74 9.74 1149 11 49 11.4 high Conclusion COVID1 COVID- (Peru 20 202 100 00 1,0 393 93 3,9 4. 649 6 64.9 19. 292 2 29.2 5. 9.7 114 11. 10 0 1, 39 3, 64. 29. 9.

Abstract This study aimed to evaluate the pharmacological trends in patients with COVID-19 from a hospital in Peru during the first wave of the pandemic. Retrospective study conducted between April and September 2020. The medical records of patients hospitalized for COVID-19 pneumonia at the Dos de Mayo National Hospital (Lima, Peru) were reviewed. Of a total of 3103 patients, 381 medical records were included (77.4% male, median age: 44 years). The use of four prehospital drugs increased (azithromycin, ivermectin, corticosteroids, and ceftriaxone), while the in-hospital use of six drugs (ceftriaxone, azithromycin, hydroxychloroquine, ivermectin, corticosteroid pulse, and prophylactic anticoagulation) decreased and in-hospital anticoagulation use decreased. These findings suggest that the management of COVID-19 has varied during the first wave of the pandemic, typically increasing prehospital drug use and decreasing inpatient use.

Resumen Con el objetivo de evaluar las tendencias en el uso de fármacos en pacientes con la COVID-19 de un hospital del Perú durante la primera ola de la pandemia se realizó un estudio retrospectivo entre abril y septiembre del 2020. Se revisaron las historias clínicas de pacientes hospitalizados por neumonía por COVID-19 en el Hospital Nacional Dos de Mayo (Lima, Perú). De un total de 3103 pacientes, se incluyeron 381 historias clínica (77,4% varones y mediana de edad de 44 años). Se observó un incremento del uso de cuatro fármacos prehospitalarios (azitromicina, ivermectina, corticoides y ceftriaxona), y una disminución del uso de seis fármacos intrahospitalarios (ceftriaxona, azitromicina, hidroxicloroquina, ivermectina, pulso de corticoides y anticoagulación profiláctica); además, el uso de anticoagulación intrahospitalaria aumentó. Estos hallazgos sugieren que el manejo de la COVID-19 varió durante la primera ola de la pandemia, aumentando el uso de fármacos prehospitalarios y disminuyendo el uso de fármacos intrahospitalarios.

Abstract This study aimed to evaluate the pharmacological trends in patients with COVID-19 from a hospital in Peru during the first wave of the pandemic. Retrospective study conducted between April and September 2020. The medical records of patients hospitalized for COVID-19 pneumonia at the Dos de Mayo National Hospital (Lima, Peru) were reviewed. Of a total of 3103 patients, 381 medical records were included (77.4% male, median age: 44 years). The use of four prehospital drugs increased (azithromycin, ivermectin, corticosteroids, and ceftriaxone), while the in-hospital use of six drugs (ceftriaxone, azithromycin, hydroxychloroquine, ivermectin, corticosteroid pulse, and prophylactic anticoagulation) decreased and in-hospital anticoagulation use decreased. These findings suggest that the management of COVID-19 has varied during the first wave of the pandemic, typically increasing prehospital drug use and decreasing inpatient use.

Resumen Con el objetivo de evaluar las tendencias en el uso de fármacos en pacientes con la COVID-19 de un hospital del Perú durante la primera ola de la pandemia se realizó un estudio retrospectivo entre abril y septiembre del 2020. Se revisaron las historias clínicas de pacientes hospitalizados por neumonía por COVID-19 en el Hospital Nacional Dos de Mayo (Lima, Perú). De un total de 3103 pacientes, se incluyeron 381 historias clínica (77,4% varones y mediana de edad de 44 años). Se observó un incremento del uso de cuatro fármacos prehospitalarios (azitromicina, ivermectina, corticoides y ceftriaxona), y una disminución del uso de seis fármacos intrahospitalarios (ceftriaxona, azitromicina, hidroxicloroquina, ivermectina, pulso de corticoides y anticoagulación profiláctica); además, el uso de anticoagulación intrahospitalaria aumentó. Estos hallazgos sugieren que el manejo de la COVID-19 varió durante la primera ola de la pandemia, aumentando el uso de fármacos prehospitalarios y disminuyendo el uso de fármacos intrahospitalarios.

Aim: To determine the prevalence and the factors associated with the publication of scientific articles in medical residents of Peru. Subjects and methods: Cross-sectional analytical study using the data obtained by the National Survey for Resident Physicians 2016 (ENMERE-2016), carried out virtually during June 2016. Population: physicians who live in a university in Peru. Sample: residents who voluntarily participated in ENMERE-2016. Outcome of interest: have published at least one scientific article. Sociodemographic variables were collected, from the university, from the headquarters, from the residence, from the resident';s perception, and from depressive symptoms. To evaluate the factors associated with having published a scientific article, crude and adjusted prevalence ratios were calculated with their 95% confidence intervals. Results: Data from 1062 residents (42.2% female) were analyzed, of which 118 (11.1%) published some scientific paper during the resident. In the adjusted analysis, to study the superior years of residency, to have performed some external rotation outside the country and to have a higher score in the overall opinion of the training process were variables directly associated with having published some scientific article. While the female sex, being over 35 years old and presenting with depressive symptoms were variables inversely associated with this outcome. Conclusion: Approximately one in ten residents published a scientific article during the residency. This was less prevalent in women, in older residents, in those who were in lower years of residence, in those who did not perform any rotation outside the country, in those who had a worse opinion of the training process, and in those with depressive symptoms.

Objetivo: Determinar la prevalencia y los factores asociados a publicar artículos científicos en médicos residentes de Perú. Sujetos y métodos: Estudio transversal analítico usando los datos obtenidos por la Encuesta Nacional para Médicos Residentes 2016 (ENMERE-2016), realizada virtualmente durante junio de 2016. Población: los médicos que realizan su residencia en alguna universidad de Perú. Muestra: los residentes que voluntariamente participaron en la ENMERE-2016. Desenlace de interés: autorreporte de haber publicado al menos un artículo científico. Se recogieron variables sociodemográficas, de la universidad, de la sede, de la residencia, de la percepción del residente y de síntomas depresivos. Para evaluar los factores asociados a haber publicado algún artículo científico se calcularon razones de prevalencia crudas y ajustadas con sus intervalos de confianza al 95%. Resultados: Se analizaron datos de 1.062 residentes (42,2% de sexo femenino), de los cuales 118 (11,1%) publicaron algún artículo científico durante la residencia. En el análisis ajustado, cursar los años superiores de la residencia, haber realizado alguna rotación externa fuera del país y tener una puntuación más alta en la opinión global del proceso de formación fueron variables directamente asociadas con haber publicado algún artículo científico, en tanto que el sexo femenino, tener más de 35 años y presentar síntomas depresivos fueron variables inversamente asociadas a dicho desenlace. Conclusión: Aproximadamente uno de cada 10 residentes publicó algún artículo científico durante la residencia. Esto fue menos prevalente en las mujeres, en los residentes de mayor edad, en quienes cursaban años inferiores de la residencia, en quienes no realizaron ninguna rotación fuera del país, en quienes tuvieron una peor opinión del proceso de formación y en quienes presentaban síntomas depresivos.

Objective: To assess the association between religious commitment and having a negative attitude towards homosexual men in a group of Peruvian medical students. Materials and methods: This is a cross-sectional analytical study performed in a group of medical students who assisted to a meeting held by the International Federation of Medical Students Associations in Peru. The presence of negative attitudes towards homosexual men was assessed using a dimension of the Attitudes Towards Lesbians and Gay Men Scale. Religious commitment was assessed with the question "Do you consider yourself a religious person?" Factors associated to having negative attitudes towards homosexual men were assessed using prevalence ratios (PR) and their 95% confidence intervals (95% CI) calculated with Poisson regressions with robust variance. Results: Data from 117 participants was analyzed (62.4% were female, mean age: 20.9 ± 1.6 years). We found an association between religious commitment and having negative attitudes towards homosexual men (PR: 1.89, 95% CI: 1.07-3.37). Other associated factors were: being a woman (PR: 0.60, 95% CI: 0.38-0.95) and having a homosexual friend or relative (PR: 0.38, 95% CI: 0.24-0.61). Conclusion: In surveyed students, religious commitment was associated with having negative attitudes towards homosexual men. This suggests that there is a need for interventions that reconcile positive attitudes towards homosexuality with religiosity in medical students

Objetivo: evaluar la asociación entre compromiso religioso y presentar actitudes negativas hacia hombres homosexuales, en un grupo de estudiantes de medicina peruanos. Materiales y métodos: estudio transversal analítico realizado en estudiantes que asistieron a una asamblea estudiantil de la International Federation of Medical Students Associations en Perú. La presencia de actitudes negativas hacia hombres homosexuales se evaluó usando una dimensión de la AttitudesToward Lesbians and Gay Men Scale. El compromiso religioso se evaluó con la pregunta: ¿te consideras una persona religiosa? Los factores asociados a presentar actitudes negativas hacia hombres homosexuales fueron evaluados usando razones de prevalencia (RP) y sus intervalos de confianza al 95% (IC 95%) calculados con regresiones de Poisson con varianza robusta. Resultados: se analizaron datos de 117 participantes (62,4% fueron mujeres, edad promedio: 20,9 ± 1,6 años). Se encontró una asociación entre el compromiso religioso y presentar actitudes negativas hacia hombres homosexuales (RP: 1,89; IC 95%: 1,07-3,37). Otros factores asociados fueron ser mujer (RP: 0,60; IC 95%: 0,38-0,95) y tener algún amigo o familiar homosexual (RP: 0,38; IC 95%: ,24-0,61). Conclusión: en la población estudiantil analizadad, el compromiso religioso se asoció con la presencia de actitudes negativas hacia hombres homosexuales. Esto sugiere la necesidad de realizar intervenciones que concilien actitudes positivas frente a la homosexualidad con la religiosidad en estudiantes de medicina

Objective: To assess food habits and factors associated with the consumption of soft drinks and fast food. Subjects and Methods: Cross-sectional study in first (n = 269) and sixth year (n = 165) students of the Faculty of Medicine at the University San Martin de Porres. A questionnaire structured was applied in twoparts: the firstpart consisted of 11 questions about socio-demographic data and general food habits; the second part consisted of 12 questions and collected the frequency of consumption of various foods. Descriptive analysis was performed, bivariate and multivariate accordingly. Results: Both groups omitted mainly breakfast. Also, eating breakfast was a protective factor in the consumption of fast foods and soft drinks. Being on sixth year was a risk factor. Conclusion: Students of higher years consume fast foods and soft drinks more often, making it necessary to promote food education from the early years.

Objetivo: Determinar los hábitos alimentarios y evaluar los factores asociados al consumo de gaseosas y comida rápida. Sujetos y métodos: Estudio transversal analítico, realizado en estudiantes de primer (n=269) y sexto año (n=165) de la Facultad de Medicina de la Universidad San Martín de Porres, de Lima, Perú. Se diseñó y aplicó un cuestionario estructurado en dos partes: la primera parte constó de 11 preguntas que incluyó los datos sociodemográficos y hábitos alimentarios generales; la segunda parte constó de 12 preguntas y recolectó la frecuencia de consumo de varios alimentos. Se realizó el análisis descriptivo, bivariado y multivariado correspondiente. Resultados: Ambos grupos omitieron principalmente el desayuno. Asimismo, tomar desayuno fue un factor protector del consumo de comidas rápidas y gaseosas, y cursar sexto año como un factor de riesgo. Conclusión: Los estudiantes de años superiores consumen comidas rápidas y gaseosas con mayor frecuencia, por lo que resulta necesario promover la educación alimentaria desde los primeros años.