Pesquisa | SciELO

Abstract Introduction: In Mexico, cardiac rehabilitation (CR) as an interdisciplinary intervention with therapeutic impact in patients with heart disease is growing. There is the need to know actual conditions of CR in our country. Objectives: The objective of this National Registry is to follow-up those existing and new CR units in Mexico through the comparison between the two previous registries, RENAPREC-2009 and RENAPREC II-2015 studies. This is a descriptive study focused on diverse CR activities such as assistance training, and certification of health professionals, barriers, reference, population attended, interdisciplinarity, permanence over time, growth prospects, regulations, post-pandemic condition, integrative characteristics, and scientific research. Results: Data were collected from 45 CR centers in the 32 states, 75.5% are private practice units, 67% are new, 33% were part of RENAPREC II-2015, and 17 have continued since 2009. With a better distribution of CR units along the territory, the median reference of candidates for CR programs is 9% with a significant reduction into tiempo of enrollment to Phase II admission (19 ± 11 days). Regarding to previous registries, the coverance of Phases I, II, and III is 71%, 100%, and 93%, respectively; and a coverance increases in evaluation, risk stratification, and prescription, more comprehensive attendance and prevention strategies. Conclusions: CR in Mexico has grown in the past 7 years. Even there is still low reference and heterogeneity in specific processes, there are strengths such as interdisciplinarity, scientific professionalization of specialists, national diversification, and an official society that are consolidated over time.

https://doi.org/10.24875/acm.22000235

Prevalencia de Giardia lamblia en escolares y en otras subpoblaciones peruanas (1990-2018): una revisión sistemática y metaanálisis
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Cabrera, Rufino

; Vargas-Herrera, Javier

; Whittembury, Alvaro

Revista de Investigaciones Veterinarias del Perú

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Abr 2023, Volume 34 Nº 2 elocation e21263

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT The study aimed to determine the prevalence and distribution of Giardia lamblia in the Peruvian population between 1990 and 2018. A systematic review and meta-analysis of cross-sectional studies was carried out. It was included original studies on the prevalence of G. lamblia, intestinal parasitism or cohort studies that included prevalence data, and diagnosed by parasitological examination, antigen detection, PCR or genetic analysis, published between 1990 and 2018 in Spanish, English, Portuguese or French and carried out in humans. Searches were performed in PubMed, Scopus, LILACS, SciELO, LIPECS, Google Scholar, and ALICIA. Analysis of heterogeneity was performed using Cochrane's Q test and publication bias using Egger's method with StatsDirect v. 3.2.7. The analysis included 33 sources that had information from 37 studies involving 10 109 individuals. The combined prevalence by the random effects method in the 37 studies was 30.4% (CI 95% 25.2-35.8); however, when analysing the subgroup in preschoolers and schoolchildren in 26 studies it was 29.1% (CI95% 24.5-34.0). Of every 100 people, 30 had G. lamblia and of every 100 pre-schoolers and schoolchildren, 29 had the parasite. Prevalence estimates according to sex and area of residence are not conclusive. Not enough studies were found in 7 other subpopulations to estimate the prevalence of G. lamblia.

RESUMEN El estudio tuvo como objetivo determinar la prevalencia y distribución de Giardia lamblia en la población peruana entre 1990 y 2018. Se realizó una revisión sistemática y metaanálisis de estudios transversales. Se incluyeron estudios originales sobre prevalencia de G. lamblia, parasitismo intestinal o estudios de cohorte que incluían datos de prevalencia; diagnosticados por examen parasitológico, detección de antígenos, PCR o análisis genético, publicados entre 1990 y 2018 en español, inglés, portugués o francés y realizados en humanos. Las búsquedas se realizaron en PubMed, Scopus, LILACS, ScieELO, LIPECS, Google Académico y ALICIA. El análisis de heterogeneidad se realizó mediante la prueba de Q de Cochrane y el sesgo de publicación mediante el método de Egger con el software StatsDirect v. 3.2.7. Se incluyeron 33 fuentes que tenían información de 37 estudios donde participaron 10 109 individuos. La prevalencia combinada por el método de efectos aleatorios en los 37 estudios fue 30.4% IC95% (25.2-35.8); sin embargo, al análisis en el subgrupo en preescolares y escolares en 26 estudios fue 29.1% IC95% (24.5-34.0). De cada 100 personas, 30 tenían G. lamblia y de cada 100 preescolares y escolares, 29 tenían el parásito. La estimación de la prevalencia de acuerdo con el sexo y al área de residencia no son concluyentes. No se encontraron suficientes estudios en otras 7 subpoblaciones para estimar la prevalencia de G. lamblia.

https://doi.org/10.15381/rivep.v34i2.21263

Automated coding and selection of causes of death in Peru: a descriptive study, 2016-2019
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Vargas-Herrera, Javier

; Miki, Janet

; Wong, Liliana López

; Monzón, Jorge Miranda

; Villanueva, Rodolfo

Epidemiologia e Serviços de Saúde

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2023, Volume 32 Nº 3 elocation e2023024

Resumo: Pt Es En | Texto: Pt Es En | PDF: Pt | PDF: Es | PDF: En

Resumo Objetivo: descrever o desempenho de um software na seleção automática da causa básica de morte no Peru, entre 2016 e 2019. Métodos: estudo descritivo do desempenho de um software na seleção automatizada da causa básica de morte ao longo dos anos (teste qui-quadrado de tendência) e da correlação entre a forma de declaração de óbito e o desempenho do software (coeficientes de correlação e determinação). Resultados: foram analisadas 446.217 declarações de óbito; a proporção de declarações com causa básica de morte aumentou de 69,6%, em 2016, para 78,8%, em 2019 (p-valor < 0,001); observou-se correlação linear direta entre as declarações eletrônicas de óbito e o desempenho do software (coeficiente de correlação = 0,95; R2 = 0,89). Conclusão: o software apresentou bom desempenho na seleção automática da causa básica de morte, com aumento significativo entre 2016 e 2019.

Resumen Objetivo: describir el desempeño de un software en la selección automática de la causa básica de muerte en Perú, entre 2016 y 2019. Métodos: estudio descriptivo de la tendencia del desempeño de un software para seleccionar la causa básica de muerte a través de los años (chi cuadrado de tendencia) y la correlación entre los certificados de defunción electrónicos y el desempeño del software (coeficientes de correlación y determinación). Resultados: se analizaron 446.217 certificados; la proporción de certificados con causa básica de muerte aumentó de 69,6% en 2016 a 78,8% en 2019 (p-valor < 0,001); se observó una correlación lineal directa entre certificados electrónicos y el desempeño del software (coeficiente de correlación = 0,95; R2 = 0,89). Conclusión: el software presentó un buen desempeño en la selección de la causa básica de muerte y aumentó significativamente entre 2016 y 2019.

Abstract Objective: to describe software performance in the automatic selection of the underlying cause of death in Peru, between 2016 and 2019. Methods: this was a descriptive study on the software performance in the automated selection of the underlying cause of death over the years (chi-square test for trend) and the correlation between the type of death certificate and software performance (correlation coefficient and coefficient of determination). Results: a total of 446,217 death certificates were analyzed; the proportion of death certificates with the underlying cause of death increased from 69.6% in 2016 to 78.8% in 2019 (p-value < 0.001); it could be seen a direct linear correlation between electronic death certificates and software performance (correlation coefficient = 0.95; R2 = 0.89). Conclusion: the software showed good performance in the automatic selection of the underlying cause of death, with a significant increase between 2016 and 2019.

https://doi.org/10.1590/s2237-96222023000300005.en

Diferencias en la gravedad del choque hemorrágico en mujeres con placenta previa y acretismo placentario antes y durante la pandemia de COVID-19
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Nares Torices, Miguel Ángel

; Hernández Pacheco, José Antonio

; Ramírez Calvo, José Antonio

; Flores Cortés, Mildred

; Becerra Navarro, Norma Patricia

; Martínez Hueyopa, Heidi Guadalupe

; Balladares Nava, Elisa Madai

; Serna-Castellanos, Karla Estela

; Brito Brito, Benjamín

; Vila Herrera, Salvador

; Rangel Vargas, Uriel Emmanuel

; Auqui Valarezo, Sandra Verónica

; Mota Calzada, Javier

Medicina crítica (Colegio Mexicano de Medicina Crítica)

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2023, Volume 37 Nº 1 Páginas 31 - 34

Resumo: Es En Pt | Texto: Es En Pt | PDF: Es | PDF: En | PDF: Pt

Resumen: Introducción: estudios previos han mostrado una mayor incidencia de todas las causas de hemorragia postparto durante la pandemia de COVID-19. El acretismo placentario es una causa frecuente de hemorragia postparto. Objetivo: determinar las diferencias en la severidad del choque hemorrágico y la cantidad de sangrado en mujeres con diagnóstico del espectro placenta previa-acretismo, antes de la pandemia y durante la pandemia por COVID-19. Material y métodos: en un estudio con cohortes comparativas de mujeres con placenta previa-acretismo, atendidas en el Instituto Nacional de Perinatología, durante el periodo de enero de 2017 a diciembre de 2019, grupo I (prepandemia), y de enero de 2020 a marzo de 2022, grupo II (pandemia), se comparó entre los grupos la cantidad de hemorragia y la clase del choque hemorrágico de acuerdo a ATLS. Resultados: se estudió a 277 mujeres, 211 fueron del grupo I (pre-COVID-19) y 66 del grupo II (COVID-19), se observó una mayor cantidad de sangrado durante la pandemia de COVID versus la fase pre-COVID (2,150.56 ± 1,910.08 mL versus 1,246.34 ± 1,494.1 mL) p = 0.001, existieron diferencias en las proporciones de la gravedad del choque hemorrágico en la fase de pandemia para las clases III y IV. Conclusión: se encontró un incremento en la cantidad de sangrado y gravedad del choque durante la pandemia de COVID-19.

Abstract: Introduction: previous studies have shown an increased incidence of all-cause postpartum hemorrhage during the COVID-19 pandemic. Placental accreta is a frequent cause of hemorrhagic shock. Objective: determine the severity of shock and the amount of bleeding during the COVID-19 pandemic in women diagnosed with placenta previa and placental accreta. Material and methods: in a comparative cohort study of women with placenta previa and accreta treated at the National Institute of Perinatology during the period from January 2017 to December 2019 group I (pre-pandemic) and from January 2020 to March 2022 group II (pandemic) the amount of hemorrhage and the class of hemorrhagic shock according to ATLS were compared between the groups. Results: 277 women were studied, 211 were from group I (pre COVID-19) and 66 from group II (COVID-19). A greater amount of bleeding was observed during the COVID pandemic versus the pre COVID phase (2,150.56 ± 1,910.08 mL vs 1,246.34 ± 1,494.1 mL) p = 0.001, there were differences in the proportions of severity of hemorrhagic shock in the pandemic phase for classes III and IV. Conclusion: an increase in the amount of bleeding and severity of shock was found during the COVID-19 pandemic.

Resumo: Introdução: estudos anteriores mostraram uma maior incidência de hemorragia pós-parto de todas as causas durante a pandemia de COVID-19. O acretismo placentário é uma causa frequente de hemorragia pós-parto. Objetivo: determinar as diferenças na gravidade do choque hemorrágico e na quantidade de sangramento em mulheres diagnosticadas com o espectro de placenta prévia-acretismo antes da pandemia e durante a pandemia de COVID-19. Material e métodos: em um estudo de coorte comparativo de mulheres com placenta prévia e acreta tratadas no Instituto Nacional de Perinatologia durante o período de janeiro de 2017 a dezembro de 2019, grupo I (pré-pandemia) e de janeiro de 2020 a março de 2022, grupo I II (pandemia) a quantidade de sangramento e a classe de choque hemorrágico de acordo com o ATLS foram comparadas entre os grupos. Resultados: foram estudadas 277 mulheres, 211 eram do grupo I (pré-COVID-19) e 66 do grupo II (COVID-19). Observou-se uma maior quantidade de sangramento durante a pandemia de COVID versus a fase pré-COVID (2,150.56 ± 1,910.08 mL vs 1,246.34 ± 1,494.1 ml) p = 0.001, houve diferenças nas proporções da gravidade do choque hemorrágico na fase pandêmica para as classes III e IV. Conclusão: um aumento na quantidade de sangramento e gravidade do choque foi encontrado durante a pandemia de COVID-19.

https://doi.org/10.35366/109960

Automated coding and selection of causes of death in Peru: a descriptive study, 2016-2019
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Vargas-Herrera, Javier

; Miki, Janet

; Wong, Liliana López

; Monzón, Jorge Miranda

; Villanueva, Rodolfo

Epidemiologia e Serviços de Saúde

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2023, Volume 32 Nº 3 elocation e2023024

Resumo: En Es Pt | Texto: En Es Pt | PDF: En | PDF: Es | PDF: Pt

https://doi.org/10.1590/s2237-96222023000300005.en

Estrés laboral docente, e-learning y tiempos de COVID-19.
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Álvarez Silva, Luis Antonio

; Herrera López, Pablo Samuel

; Lániz Vargas, Christopher Alcides

; González Zhagñay, Javier Oswaldo

Podium

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Nov 2022, Nº 41 Páginas 105 - 118

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract The objective of this research is to analyze the level of work stress to which teachers from various educational centers were exposed, and who had to engage in the e-learning modality as a result of the pandemic caused by COVID- 19in the year 2020. The study design is non-experimental with a cross-sectional type and a descriptive scope. To achieve this, the Karasek test was used, the same one that measures the work stress variable and that in this exercise presented an adequate level of internal consistency (α = 0.85). The sample consisted of 272 teachers from different academic units, in whom the information was collected in peak months of the health crisis. In a conclusion, it was obtained that the adaptation to the new modality, the late hours of connectivity, the lack of strategic planning, and the negative news in general; denoted a high rate of job stress.

Resumen La presente investigación tiene como objetivo analizar el nivel de estrés laboral al que estuvieron expuestos los docentes de varios centros educativos, y quienes tuvieron que acoplarse a la modalidad e-learning a consecuencia de la pandemia provocada por el COVID- 19en el año 2020. El diseño de estudio es no experimental de tipología transversal y alcance descriptivo. Para su consecución se utilizó la prueba Karasek, la misma que mide la variable de estrés laboral y que en este ejercicio presentó un adecuado nivel de consistencia interna (α = 0.85). La muestra estuvo conformada por 272 docentes de diferentes unidades académicas, en quienes se efectuó el levantamiento de información en meses pico de crisis sanitaria. Como conclusión se obtuvo que la adaptación a la nueva modalidad, las altas horas de conectividad, la falta de planificación estratégica, y las noticias negativas en general denotaron un alto índice de estrés laboral.

https://doi.org/10.31095/podium.2022.41.7 551 downloads

Code infarction initiative of Bajio region, during the pandemic by COVID-19 in a reconversion hospital
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Villar-Valencia, Cristian Adrián

; Hernández-González, Martha Alicia

; Borrayo-Sánchez, Gabriela

; Celis-Quintal, Juan German

; Solorio-Meza, Sergio Eduardo

; Medina-Torres, Oscar Samuel

; Gutiérrez-Galván, Maraí Xochitl

; Rodríguez-Martínez, Braulio

; Prado-Rodríguez, Luis Humberto

; Vázquez-Morones, Ana Laura

; Alatoma-Medina, Juan Pablo

; Hernández-Estala, Jorge

; Patiño-Amaya, Aristóteles

; Magdaleno-Serrano, Hugo Ivan

; Rodríguez-Déniz, Carmen

; Arellano-Sotelo, Hugo

; Nava-Hernández, Guillermo

; Ramírez-Vázquez, Ricardo

; Chimal-Flores, Marco Antonio

; Alegría-Peredia, Emiliano

; Ramos-González, Gerardo Rubén

; Pérez-Benítez, Rigoberto

; Bermúdez-Acévez, Erik

; Valencia-Martínez, Hypatia

; Segovia-Solís, Hugo

; López-Varela, Manuel

; Monroy-Córdoba, Doryan

; Marmolejo-López, Adriana

; Báez-Montes, Alfredo

; Hernández-Cerqueda, Fabián

; Nolasco-Muñoz, Luis Ricardo

; Vargas-Ramírez, Luis Manuel

; Celis-Quintal, Juan German

; Bernal-Ruíz, Enrique Alfredo

; Delgado-Sánchez, Anabella

; Sánchez-López, José Manuel

; Bautista-López, Germán Ramón

; Acevedo-Gómez, Pablo Francisco

; Acuña-Valerio, Jorge Francisco

; González-Ortíz, Oracio

; Hernández-Padilla, Adolfo Asahel

; Solórzano-Vázquez, Marco Alejandro

; Franco-Herrera, Noel

; González, Luis Jonathan

; Reyes-Álvarez, José Miguel

; Salinas-Cavazos, Iván Rosendo

; Tiscareño-Villanueva, Ashby Daniel

; Vidrio-Villaseñor, Ramiro

; Fernández-Yáñez, Gabriel

; Meza, Ma. Guadalupe

; Nucamendi-Solórzano, Freeman Issac

; Sandoval-Uribe, José de Jesús

; Sotelo-García, Luis David

; Zamoaya-Paz, Luis Carlos

; Espriu, Donovan Fernando

; García-Rodríguez, Román

; López-Ibarra, Daniel Eugenio

; López-Valencia, Andrea Janeth

; Villar-Valencia, Cristian Adrián

; Navarro-Pérez-Macedo, Javier

Cardiovascular and metabolic science

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Set 2022, Volume 33 Nº 3 Páginas 97 - 105

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract: Introduction: Acute myocardial infarction has a high prevalence and possibility of death if timely care is not given. It is possible that treatment could be delayed during a health crisis such as the COVID-19 pandemic. Objective: The objective of this study was to evaluate the impact of the COVID-19 pandemic on the function of the infarction code in the High Specialty Medical Unit of our institution. The medical indicators of acute coronary ischemic syndrome with ST-segment elevation were compared at two times: before the COVID-19 pandemic and during it. Material and methods: An ambispective, analytical, comparative cohort study was conducted, comparing the periods of February-September 2019 and February-September 2020, in the High Specialty Medical Unit, Centro Médico del Bajío number 1, Instituto Mexicano del Seguro Social, Leon, Guanajuato, Mexico. All patients older than 18 years with clinical, electrocardiographic, and enzymatic data of acute coronary ischemic syndrome, accepted in the medical network as infarction code registered in the National Registry of Acute Coronary Ischemic Syndromes (RENASCA) electronic case report form were included in the study. Results: The independent samples t-test was used to determine the impact of the infarction code initiative based on the reperfusion therapies performed, the door-to-needle, the door-to-balloon time, and the ischemia time. There was a significant difference in the reperfusion strategy, with greater thrombolysis during the COVID-19 pandemic (57.4% versus 72.6%, odds ratio [OR] 1.97, 95% confidence interval [CI] 0.49-0.82, p < 0.001), as well as reperfusion criteria (21.03% versus 35.37%, OR 2.05, 95% CI 0.53-0.80, p < 0.0001). Mortality was not different between the time periods. Conclusions: The COVID-19 pandemic has not impacted operation of the infarction code in the High Specialty Medical Unit Centro Médico del Bajío number 1 because the medical indicators of acute coronary ischemic syndrome with ST-segment elevation did not change.

resumen está disponible en el texto completo

https://doi.org/10.35366/107622

La cobertura de muertes con certificación médica en el Perú, 2012-2019
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Vargas-Herrera, Javier

; Miranda Monzón, Jorge

; Lopez Wong, Liliana

; Miki Ohno, Janet

Anales de la Facultad de Medicina

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Abr 2022, Volume 83 Nº 2 Páginas 123 - 129

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

RESUMEN El fortalecimiento de los sistemas de registro civil y estadísticas vitales (RCEV) es indispensable para evaluar el impacto de las intervenciones sanitarias y los efectos de las emergencias sanitarias. El Perú enfrentó la pandemia de la COVID-19, en pleno proceso de fortalecimiento del sistema de RCEV, en el que destacó la implementación de SINADEF, lo que le permitió mejorar la calidad y la cobertura de la información sobre la mortalidad. Se realizó una recopilación de información de diversas fuentes de información pública para calcular la cobertura de la mortalidad en el Perú para el periodo 2012 a 2019. La cobertura de las muertes con certificación médica ascendió de 57,65% en 2016 a 71,6% en 2019 y mejoró en todas las regiones del Perú a nivel nacional, adicionalmente, la certificación en línea de las defunciones ascendió de 29% en 2017 a 86% en 2020. El SINADEF ha permitido implementar un sistema de vigilancia rápida de la mortalidad y medir el exceso de la mortalidad que se viene produciendo en el contexto de la pandemia.

ABSTRACT The strengthening of civil registration and vital statistics (RCEV) systems is essential to assess the impact of health interventions and the effects of health emergencies. Peru faced the COVID-19 pandemic, in the process of strengthening the RCEV system, in which the implementation of SINADEF stood out, which allowed it to improve the quality and coverage of information on mortality. A compilation of information from various public information sources was carried out to calculate the coverage of mortality in Peru for the period 2012 to 2019. The coverage of deaths with medical certification rose from 57.65% in 2016 to 71.6% in 2019 and improved in all regions of Peru at the national level, additionally, online certification of deaths rose from 29% in 2017 to 86% in 2020. The SINADEF has made it possible to implement a rapid mortality surveillance system and measure the excess mortality that is occurring in the context of the pandemic.

https://doi.org/10.15381/anales.v83i2.23011

Supervivencia de los trabajadores de salud infectados por SARS-CoV-2 en el contexto de la vacunación contra la COVID-19 en el Perú
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Escobar-Agreda, Stefan

; Silva-Valencia, Javier

; Rojas-Mezarina, Leonardo

; Vargas-Herrera, Javier

Anales de la Facultad de Medicina

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Abr 2021, Volume 82 Nº 2 Páginas 106 - 112

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

ABSTRACT Objectives. To evaluate the survival of health personnel infected by SARS-CoV-2 in the context of the vaccination process against COVID-19 in Peru. Methods. A survival analysis was performed using data from national health databases. Data from people between 18 and 59 years old infected with SARS-CoV-2 as evidenced by molecular or antigenic tests were included. Kaplan Meier graphs were produced to compare the survival of health personnel and the rest of the population during 2021 and health personnel during the first and second wave of mortality in Peru in 2020 and 2021, respectively. Results. Data from 998 295 people were included. The average age was 41.2 years (SD 15.8) and 485 167 (48.6%) were women. A higher level of survival of health workers after vaccination was found compared to the general population and to the population of health workers before vaccination. It was evidenced that, at the beginning of the second wave, the risk of dying for health workers was twice that of the first wave (HR = 2). After vaccination (in the sixth month of the second wave), the risk of dying decreased to 87.5% less than in the first wave (HR = 0.125). Conclusions. A positive change has been evidenced in the level of survival of health personnel infected by SARS-CoV-2 during the context of vaccination against COVID-19 in Peru.

RESUMEN Objetivos. Evaluar la supervivencia de los trabajadores de salud infectados por SARS-CoV-2 en el contexto del proceso de vacunación contra la COVID-19 en el Perú. Métodos. Se realizó un análisis de supervivencia a partir de datos provenientes de las bases nacionales en salud. Se incluyó datos de personas entre 18 y 59 años infectadas por SARS-CoV-2 evidenciada por prueba molecular o antigénica. Se elaboraron gráficos de Kaplan Meier para comparar la sobrevida de los trabajadores de salud y el resto de la población durante el año 2021 y el trabajador de salud durante la primera y segunda ola de mortalidad en el Perú en el 2020 y 2021, respectivamente. Resultados. Se incluyeron datos de 998 295 personas. La edad promedio fue 41,2 años (DE 15,8) y 485 167 (48,6%) fueron mujeres. Se encontró un mayor nivel de sobrevida de los trabajadores de salud después de la vacunación con respecto a la población en general y a la población de los trabajadores de salud antes de la vacunación. Se evidenció que, al inicio de la segunda ola, el riesgo de morir de los trabajadores de salud era el doble del que tenían en la primera ola (HR=2). Después de la vacunación (en el sexto mes de la segunda ola), el riesgo de morir disminuyó hasta 87,5% menos que en la primera ola (HR=0,125). Conclusiones. Se ha evidenciado un cambio positivo en el nivel de sobrevida de los trabajadores de salud infectado por SARS-CoV-2 durante el contexto de la vacunación contra la COVID-19 en el Perú.

https://doi.org/10.15381/anales.v82i2.20766

10.

Consenso Colombiano para la prevención, diagnóstico y manejo de condiciones trombóticas en pacientes adultos con COVID-19: aplicando el Marco de la Evidencia a la Decisión (EtD) GRADE
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Acevedo-Peña, Juan

; Yomayusa-González, Nancy

; Cantor-Cruz, Francy

; Pinzon-Florez, Carlos

; Barrero-Garzón, Liliana

; De-La-Hoz-Siegler, Ilich

; Low-Padilla, Eduardo

; Ramírez-Ceron, Carlos

; Combariza-Vallejo, Felipe

; Arias-Barrera, Carlos

; Moreno-Cortés, Javier

; Rozo-Vanstrahlen, José

; Correa-Pérez, Liliana

; Rojas-Gambasica, José

; González-González, Camilo

; La-Rotta-Caballero, Eduardo

; Ruíz-Talero, Paula

; Contreras-Páez, Rubén

; Lineros-Montañez, Alberto

; Ordoñez-Cardales, Jorge

; Escobar-Olaya, Mario

; Izaguirre-Ávila, Raúl

; Campos-Guerra, Joao

; Accini-Mendoza, José

; Pizarro-Gómez, Camilo

; Patiño-Pérez, Adulkarín

; Flores-Rodríguez, Janine

; Valencia-Moreno, Albert

; Londoño-Villegas, Alejandro

; Saavedra-Rodríguez, Alfredo

; Madera-Rojas, Ana

; Caballero-Arteaga, Andrés

; Díaz-Campos, Andrés

; Correa-Rivera, Felipe

; Mantilla-Reinaud, Andrés

; Becerra-Torres, Ángela

; Peña-Castellanos, Ángela

; Reina-Soler, Aura

; Escobar-Suarez, Bibiana

; Patiño-Escobar, Bonell

; Rodríguez-Cortés, Camilo

; Rebolledo-Maldonado, Carlos

; Ocampo-Botero, Carlos

; Rivera-Ordoñez, Carlos

; Saavedra-Trujillo, Carlos

; Figueroa-Restrepo, Catalina

; Agudelo-López, Claudia

; Jaramillo-Villegas, Claudia

; Villaquirán-Torres, Claudio

; Rodríguez-Ariza, Daniel

; Rincón-Valenzuela, David

; Lemus-Rojas, Melissa

; Pinto-Pinzón, Diego

; Garzón-Díaz, Diego

; Cubillos-Apolinar, Diego

; Beltrán-Linares, Edgar

; Kondo-Rodríguez, Emilio

; Yama-Mosquera, Erica

; Polania-Fierro, Ernesto

; Real-Urbina, Evalo

; Rosas-Romero, Andrés

; Mendoza-Beltrán, Fernán

; Guevara-Pulido, Fredy

; Celia-Márquez, Gina

; Ramos-Ramos, Gloria

; Prada-Martínez, Gonzalo

; León-Basantes, Guillermo

; Liévano-Sánchez, Guillermo

; Ortíz-Ruíz, Guillermo

; Barreto-García, Gustavo

; Ibagón-Nieto, Harold

; Idrobo-Quintero, Henry

; Martínez-Ramírez, Ingrid

; Solarte-Rodríguez, Ivan

; Quintero-Barrios, Jorge

; Arenas-Gamboa, Jaime

; Pérez-Cely, Jairo

; Castellanos-Parada, Jeffrey

; Garzón-Martínez, Fredy

; Luna-Ríos, Joaquín

; Lara-Terán, Joffre

; Vargas-Fodríguez, Johanna

; Dueñas-Villamil, Rubén

; Bohórquez-Feyes, Vicente

; Martínez-Acosta, Carlos

; Gómez-Mesa, Esteban

; Gaitán-Rozo, Julián

; Cortes-Colorado, Julián

; Coral-Casas, Juliana

; Horlandy-Gómez, Laura

; Bautista-Toloza, Leonardo

; Palacios Palacios, Leonardo

; Fajardo-Latorre, Lina

; Pino-Villarreal, Luis

; Rojas-Puentes, Leonardo

; Rodríguez-Sánchez, Patricia

; Herrera-Méndez, Mauricio

; Orozco-Levi, Mauricio

; Sosa-Briceño, Mónica

; Moreno-Ruíz, Nelson

; Sáenz-Morales, Oscar

; Amaya-González, Pablo

; Ramírez-García, Sergio

; Nieto-Estrada, Víctor

; Carballo-Zárate, Virgil

; Abello-Polo, Virginia

Acta Medica Colombiana

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Mar 2021, Volume 46 Nº 1 Páginas 51 - 72

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract Recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. In this context, the aim was to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: A rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: Recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.

https://doi.org/10.36104/amc.2021.2078 253 downloads

11.

Consenso colombiano para la prevención, el diagnóstico y el tratamiento de condiciones trombóticas en adultos con COVID-19: aplicando el Marco de la Evidencia a la Decisión (EtD) GRADE
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Acevedo-Peña, Juan

; Yomayusa-González, Nancy

; Cantor-Cruz, Francy

; Pinzón-Flórez, Carlos

; Barrero-Garzón, Liliana

; De-La-Hoz-Siegler, Ilich

; Low-Padilla, Eduardo

; Ramírez-Cerón, Carlos

; Combariza-Vallejo, Felipe

; Arias-Barrera, Carlos

; Moreno-Cortés, Javier

; Rozo-Vanstrahlen, José

; Correa-Pérez, Liliana

; Rojas-Gambasica, José

; González-González, Camilo

; La-Rotta-Caballero, Eduardo

; Ruíz-Talero, Paula

; Contreras-Páez, Rubén

; Lineros-Montañez, Alberto

; Ordoñez-Cardales, Jorge

; Escobar-Olaya, Mario

; Izaguirre-Ávila, Raúl

; Campos-Guerra, Joao

; Accini-Mendoza, José

; Pizarro-Gómez, Camilo

; Patiño-Pérez, Adulkarín

; Flores-Rodríguez, Janine

; Valencia-Moreno, Albert

; Londoño-Villegas, Alejandro

; Saavedra-Rodríguez, Alfredo

; Madera-Rojas, Ana

; Caballero-Arteagam, Andrés

; Díaz-Campos, Andrés

; Correa-Rivera, Felipe

; Mantilla-Reinaud, Andrés

; Becerra-Torres, Ángela

; Peña-Castellanos, Ángela

; Reina-Soler, Aura

; Escobar-Suarez, Bibiana

; Patiño-Escobar, Bonell

; Rodríguez-Cortés, Camilo

; Rebolledo-Maldonado, Carlos

; Ocampo-Botero, Carlos

; Rivera-Ordoñez, Carlos

; Saavedra-Trujillo, Carlos

; Figueroa-Restrepo, Catalina

; Agudelo-López, Claudia

; Jaramillo-Villegas, Claudia

; Villaquirán-Torres, Claudio

; Rodríguez-Ariza, Daniel

; Rincón-Valenzuela, David

; Lemus-Rojas, Melissa

; Pinto-Pinzón, Diego

; Garzón-Díaz, Diego

; Cubillos-Apolinar, Diego

; Beltrán-Linares, Edgar

; Kondo-Rodríguez, Emilio

; Yama-Mosquera, Erica

; Polania-Fierro, Ernesto

; Real-Urbina, Evalo

; Rosas-Romero, Andrés

; Mendoza-Beltrán, Fernán

; Guevara-Pulido, Fredy

; Celia-Márquez, Gina

; Ramos-Ramos, Gloria

; Prada-Martínez, Gonzalo

; León-Basantes, Guillermo

; Liévano-Sánchez, Guillermo

; Ortíz-Ruíz, Guillermo

; Barreto-García, Gustavo

; Ibagón-Nieto, Harold

; Idrobo-Quintero, Henry

; Martínez-Ramírez, Ingrid

; Solarte-Rodríguez, Ivan

; Quintero-Barrios, Jorge

; Arenas-Gamboa, Jaime

; Pérez-Cely, Jairo

; Castellanos-Parada, Jeffrey

; Garzón-Martínez, Fredy

; Luna-Ríos, Joaquín

; Lara-Terán, Joffre

; Vargas-Rodríguez, Johanna

; Dueñas-Villamil, Rubén

; Bohórquez-Reyes, Vicente

; Martínez-Acosta, Carlos

; Gómez-Mesa, Esteban

; Gaitán-Rozo, Julián

; Cortes-Colorado, Julián

; Coral-Casas, Juliana

; Horlandy-Gómez, Laura

; Bautista-Toloza, Leonardo

; Palacios, Leonardo Palacios

; Fajardo-Latorre, Lina

; Pino-Villarreal, Luis

; Rojas-Puentes, Leonardo

; Rodríguez-Sánchez, Patricia

; Herrera-Méndez, Mauricio

; Orozco-Levi, Mauricio

; Sosa-Briceño, Mónica

; Moreno-Ruíz, Nelson

; Sáenz-Morales, Oscar

; Amaya-González, Pablo

; Ramírez-García, Sergio

; Nieto-Estrada, Víctor

; Carballo-Zárate, Virgil

; Abello-Polo, Virginia

Revista Colombiana de Cardiología

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Out 2020, Volume 27 Nº 5 Páginas 446 - 460

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract Introduction: recent studies have reported the occurrence of thrombotic phenomena or coagulopathy in patients with COVID-19. There are divergent positions regarding the prevention, diagnosis, and treatment of these phenomena, and current clinical practice is based solely on deductions by extension from retrospective studies, case series, observational studies, and international guidelines developed prior to the pandemic. Objective: to generate a group of recommendations on the prevention, diagnosis and management of thrombotic complications associated with COVID-19. Methods: a rapid guidance was carried out applying the GRADE Evidence to Decision (EtD) frameworks and an iterative participation system, with statistical and qualitative analysis. Results: 31 clinical recommendations were generated focused on: a) Coagulation tests in symptomatic adults with suspected infection or confirmed SARS CoV-2 infection; b) Thromboprophylaxis in adults diagnosed with COVID-19 (Risk scales, thromboprophylaxis for outpatient, in-hospital management, and duration of thromboprophylaxis after discharge from hospitalization), c) Diagnosis and treatment of thrombotic complications, and d) Management of people with previous indication of anticoagulant agents. Conclusions: recommendations of this consensus guide clinical decision-making regarding the prevention, diagnosis, and treatment of thrombotic phenomena in patients with COVID-19, and represent an agreement that will help decrease the dispersion in clinical practices according to the challenge imposed by the pandemic.

https://doi.org/10.1016/j.rccar.2020.08.003 86 downloads

12.

Diversidad genética en dos huertos semilleros de Pinus patula Schiede ex SchltdL. et Cham.
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Méndez-Neri, Mónica

; Ramírez-Herrera, Carlos

; Vargas-Hernández, J. Jesús

; Martínez-Trinidad, Tomás

; López-Upton, Javier

; López, Pedro Antonio

Revista fitotecnia mexicana

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Mar 2020, Volume 43 Nº 1 Páginas 113 - 119

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Summary Genetic diversity is important in seed orchards to produce plants with high capability of adaptation to environmental changes; thus, the objective of this study was to evaluate the genetic diversity and structure of two asexual seed orchards of Pinus patula and to determine the degree of differentiation of each orchard. The first orchard is located at common land La Selva, municipality of Huayacocotla, Veracruz, Mexico and the second one at common land Villa Cuauhtémoc, municipality of Chignahuapan, Puebla. Mexico. Each orchard was established with phenotypically superior cloned trees selected in their own area. Foliage samples were collected from one ramet from each clone in both orchards. Microsatellite molecular markers NZPR114, NZPR5, PtTX2123, PtTX2146, PtTX3107 and PtTX3127 were used to perform the genetic diversity analysis. The average number of alleles per locus was 9.9 for both seed orchards. The observed and expected heterozygosities were 0.602 and 0.693, respectively. The fixation index was 0.125. A deficit of heterozygotes was found when both seed orchards were analyzed jointly (FIT = 0.125) and within each of the orchards (FIS = 0.105). The differentiation index was low (FST = 0.023). Most of the genetic diversity was found within the orchards with only 4.5 % between them. The genetic diversity was high in the asexual orchards of P. patula with moderate deficiency of heterozygotes and low level of differentiation between both seed orchards.

Resumen La diversidad genética es importante en los huertos semilleros para producir plantas con alta capacidad de adaptación a cambios ambientales; por lo tanto, el objetivo del presente estudio fue evaluar la diversidad y estructura genética de dos huertos semilleros asexuales de Pinus patula y determinar el grado de diferenciación de cada huerto. El primer huerto se localiza en el ejido La Selva, municipio de Huayacocotla, Veracruz, México y el segundo en el ejido Villa Cuauhtémoc, municipio de Chignahuapan, Puebla, México. Cada huerto se estableció con árboles clonados fenotípicamente superiores seleccionados en su propia área. Muestras de follaje se recolectaron de un rameto de cada clon en ambos huertos semilleros. Los marcadores moleculares de microsatélite NZPR1078, NZPR114, NZPR5, PtTX2123, PtTX2146, PtTX3107 y PtTX3127 se usaron para realizar el análisis de diversidad genética. El número promedio de alelos por locus fue 9.9 para ambos huertos semilleros. La heterocigosidad observada y la esperada fueron 0.602 y 0.693, respectivamente. El índice de fijación fue 0.125. Un déficit de heterocigotos se encontró cuando los dos huertos semilleros se analizaron en conjunto (FIT = 0.125) y dentro de cada uno de estos (FIS = 0.105). El índice de diferenciación fue bajo (FST = 0.023). La mayor parte de la diversidad genética se encontró dentro de los huertos con sólo 4.5 % entre éstos. La diversidad genética fue alta en los huertos asexuales de P. patula con deficiencias moderadas de heterocigotos y un nivel bajo de diferenciación entre ambos huertos semilleros.

https://doi.org/10.35196/rfm.2020.1.113 647 downloads

13.

Consenso Mexicano de Mieloma Múltiple
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Peña-Celaya, José A. de la

; Aguilar-Luevano, Jocelyn

; Alcivar-Cedeño, Luisa María

; Álvarez-Vera, José L.

; Anaya-Cuellar, Irene

; Añorve-Hernández, Erika

; Arana-Luna, Luara L.

; Arteaga-Ortíz, Luis

; Báez-Islas, Pamela E.

; Banda-García, Luisa I.

; Bates-Martín, Ramón A.

; Campa-Monroy, Dafne Itzel

; Cardiel-Silva, Mariela

; Castillo-Salas, Ángel de Jesús

; Cota-Rangel, Xóchitl

; Díaz-Vargas, Guillermo

; Espitia-Ríos, M. Eugenia

; Estrada-Domínguez, Patricia

; Fermín-Caminero, Denisse

; García-Camacho, Alinka

; García-Castillo, Carolina

; Garzón-Velásquez, Katheryn B.

; Gil-Rondero, Carlos

; Hernández-Colín, Ana K.

; Hernández-Ruiz, Eleazar

; Hernández-Alcántara, Areli E.

; Hernández-Cervantes, Silvia A.

; Herrera-Olivares, Wilfrido

; Ignacio-Ibarra, Gregorio

; Inclán-Alarcón, Sergio I.

; Leyto-Cruz, Faustino

; Macías-Flores, Juan P.

; Martínez-de la Vega, Andrea

; Martínez-Ramírez, Mario A.

; Martínez-Coronel, Jorge

; Medina-Coral, Jesús E.

; Meza-Dávalos, Lizeth

; Montoya-Jiménez, Leire

; Morales-Hernández, Alba

; Morales-López, Elizabeth

; Morales-Adrián, Javier de Jesús

; Morales-de Azcué, Maricruz

; Mújica-Martínez, Aldo

; Murillo-Cruz, Juan L.

; Nájera-Martínez, Jéssica

; Narváez-Sarmiento, Iris M.

; Nava-Villegas, Lorena

; Nava-Alpide, Marco A.

; Orellana-Garibay, Juan J.

; Palafox-Zaldívar, María Teresa

; Palma-Moreno, Orlando G.

; Paredes-Lozano, Eugenia P.

; Pedraza-Colín, María Luisa

; Pérez-Zúñiga, Juan M.

; Pérez-Lizardi, Alejandra B.

; Rojas-Castillejos, Flavio

; Romero-Martínez, Eduardo

; Romero-Rodelo, Hilda

; Ruiz-Contreras, Josué

; Saavedra-González, Azucena

; Saucedo-Montes, Erick

; Silva-Michel, Luis G.

; Silva-Vera, Karina

; Teomitzi-Sánchez, Óscar

; Tepepa-Flores, Fredy

; Ventura-Enríquez, Yanet

; Villela-Peña, Atenas

; Vilchis-González, Shendel P.

; Zapata-Canto, Nidia

; Zárate-Rodríguez, Pedro A.

; Alvarado-Ibarra, Martha

Gaceta médica de México

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2020, Volume 156 Supl. 2 Páginas 1 - 49

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Abstract To identify this increasingly common pathology, known as Multiple Myeloma, it is necessary to refer to the specific factors that characterize it; to this end, the classic criteria known as CRAB (hypercalcemia, renal failure, anemia and lytic lesions) are available, in which renal failure is one of the most frequent complications. Recently, 3 indisputable biomarkers have been described for the diagnostic support for Multiple Myeloma, which are: more than 10% of clonal plasma cells in BM or, a biopsy that corroborates the presence of a plasmacytoma, light chain ratio ≥100 mg/dL and more than one focal lesion on magnetic resonance imaging (MRI). A differential diagnosis for plasma cell leukemia, solitary bone plasmacytoma, and extramedullary plasmacytoma should always be considered. Being this an incurable disease, a lot of research has been done regarding its therapeutic management, whose main objective is the disappearance of plasma cells and the patient clinical improvement. Melphalan was the first drug that showed a benefit in 1958 and afterwards, with the addition of a steroid as a second drug, it was possible to improve response rates. Subsequently, different molecules were studied, forming multiple combinations, and achieving better rates of Overall Survival and Progression-Free Survival. Years later, with the arrival of proteasome inhibitors such as bortezomib, and immunomodulators such as thalidomide and lenalidomide, an important turnaround in the disease has been seen, as deeper responses, more prolonged remissions, and improvement in the quality of life of patients have been achieved. This consensus has the purpose of integrating a group of Mexican specialists and promoting the updating of this pathology.

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https://doi.org/10.24875/gmm.m20000392 223 downloads

14.

Recomendaciones para el uso racional de la prueba 25-hidroxivitamina D Resumen de política
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Herrera-Molina, Emilio

; González, Nancy Yomayusa

; Low-Padilla, Eduardo

; Oliveros-Velásquez, Juan David

; Mendivelso-Duarte, Fredy

; Gómez-Gómez, Olga Victoria

; Castillo, Ana María

; Barrero-Garzón, Liliana Isabel

; Álvarez-Moreno, Carlos Arturo

; Moscoso-Martínez, Ernesto Augusto

; Ruíz-Blanco, Pilar Cristin

; Luna-Ríos, Joaquín Gustavo

; Ortiz, Natasha

; Herrera, Emiliano Mauricio

; Guevara-Santamaría, Fabián

; Moreno-Gómez, Jairo Enrique

; Cárdenas-Ramírez, Héctor Mauricio

; González-González, Camilo Alberto

; Jannauth, María José

; Patiño-Pérez, Adulkarin

; Pinto, Diego Alejandro

; Acevedo, Juan Ramon

; Torres, Rodolfo Eduardo

; Montero, Jairo Camilo

; Acevedo, Andrés David

; Caceres, Ximena Adriana

; Acuña-Olmos, Jairo

; Arias, Carlos Andrés

; Medardo-Rozo, José

; Castellanos-Parada, Jeffrey

; López-Miranda, Ángelo Mauricio

; Pinzón-Serrano, Estefanía

; Rincón-Sierra, Oswaldo

; Isaza-Ruget, Mario

; Suárez-Ramos, María del Pilar

; Vargas-Rodríguez, Johanna

; Mejia-Gaviria, Natalia

; Moreno-Marín, Sandra Yadira

; García-Guarín, Bibiana María

; Cárdenas, Martha Lucía

; Chavarro, Luis Fernando

; Ronderos-Bernal, Camila

; Rico-Landazabal, Arturo

; Coronado-Daza, Jorge Antonio

; Alfaro-Tejeda, Mercedes Teresa

; Yama-Mosquera, Erica

; Hernández-Sierra, Astrid Patricia

; Restrepo-Valencia, César Augusto

; Arango-Álvarez, Javier

; Rosero-Olarte, Francisco Oscar Fernando

; Medina-Orjuela, Adriana

; Robayo-García, Adriana

; Carballo-Zarate, Virgil

; Rodríguez-Sánchez, Martha Patricia

; Bernal, Dora P.

; Jaramillo, Laura

; Baquero-Rodríguez, Richard

; Mejía-Gaviria, Natalia

; Aroca, Gustavo

Revista Colombiana de Nefrología

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Dez 2019, Volume 6 Nº 2 Páginas 179 - 192

Resumo: Es En | Texto: Es En | PDF: Es | PDF: En

resumen está disponible en el texto completo

Abstract The exponential increase in the request for laboratory tests of 25-Hydroxyvitamin D or [25 (OH) D has ignited the alarms and generated a strong call for attention, since it may reflect deficiencies in the standardization of clinical practice and in the use non-systematic scientific evidence for decision-making in real life, which allows to analyze the indications of the test, its frequency, interpretation and even to assess the impact for health systems, especially when contrasted with the minimum or almost. No effects of the strategy of screening or supplying indiscriminately to the general population, without considering a comprehensive clinical assessment of risks and needs of people. From a purely public health impact point of view, the consequence of massive and unspecified requests is affecting most of the health systems and institutions at the global level. The primary studies that determined average population intake values have been widely used in the formulation of recommendations in Clinical Practice Guidelines, but unfortunately misinterpreted as cut points to diagnose disease and allow the exaggerated prescription of nutritional substitution. The coefficient of variation in routine tests to measure blood levels of 25 (OH) D is high (28%), decreasing the overall accuracy of the test and simultaneously, increasing both the falsely high and falsely low values. The most recent scientific evidence analyzes and seriously questions the usefulness and the real effect of the massive and indiscriminate practice of prescribing vitamin D without an exhaustive risk analysis. The available evidence is insufficient to recommend a general substitution of vitamin D to prevent fractures, falls, changes in bone mineral density, incidence of cardiovascular diseases, cerebrovascular disease, neoplasms and also to modify the growth curve of mothers' children. They received vitamin D as a substitute during pregnancy. The recommendations presented in the document are based on the critical analysis of current evidence and the principles of good clinical practice and invite to consider a rational use of 25 (OH) D tests in the context of a clinical practice focused on people and a comprehensive assessment of needs and risks. The principles of good practice suggest that clinicians may be able to justify that the results of the 25 (OH) D test strongly influence and define clinical practice and modify the outcomes that interest people and impact their health and wellness. Currently there is no clarity on how to interpret the results, and the relationship between symptoms and 25 (OH) D levels, which may not be consistent with the high prevalence of vitamin D deficiency reported. For this reason, it is suggested to review the rationale of the request for tests for systematic monitoring of levels of 25 (OH) D or in all cases where substitution is performed. Consider the use of 25 (OH) D tests within the comprehensive evaluation of people with suspicion or confirmation of the following conditions: rickets, osteomalacia, osteoporosis, hyper or hypoparathyroidism, malabsorption syndromes, sarcopenia, metabolic bone disease.

597 downloads

15.

Asociación entre los factores sociodemográficos, obstétricos y patológicos con la muerte fetal tardía: estudio de casos y controles en un hospital de Perú
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Martínez-López, Andrés Modesto

; Vargas-Herrera, Javier Roger Raúl

; Mini-Díaz, Elsy Haydee

Anales de la Facultad de Medicina

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Jul 2019, Volume 80 Nº 3 Páginas 322 - 326

Resumo: En Es | Texto: En Es | PDF: En | PDF: Es

Introduction: In Peru, a little is known about risk factors associated with late fetal death. This is a valuable information, which have to be used in order to implement preventional strategies. Objectives: To evaluate association between late fetal death and social, demographical, obstetrical and pathological factors in a peruvian hospital. Methods: A retrospective study of cases and controls between July 2014 and June 2016. The cases were pregnant women who had intrauterine fetal death and controls were pregnant women who had a newborn alive. Educational level, profession, number of prenatal care consults (CPN), and complications as preterm birth, pre-eclampsia or intrauterine growth retardation (RCIU) were evaluated as possible associated factors. Results: 60 cases and 120 controls were included. Primary education level (OR = 4,3; 95% CI = 1,0-18,0), working occupation (OR = 3,8; 95% CI = 1,3-11,0), no CPN (OR = 21,0; 95% CI = 2,6-170,1), pre-eclampsia (OR = 4,1; 95% CI = 1,3-12,7), preterm birth (OR = 10,1; 95%CI = 4,7-21,7) and RCIU (OR = 7.0; 95%CI = 2.4-20.5) were associated with fetal mortality. Conclusion: There are social, demographical, obstetrical and pathological risk factors associated with late fetal death.

Introducción: En el Perú, poco se conoce acerca de los factores de riesgo asociados a la muerte fetal tardía, lo que se considera información valiosa para implementar estrategias de prevención. Objetivos: Evaluar la asociación entre factores sociodemográficos, obstétricos y patológicos y la muerte fetal tardía en un hospital peruano. Métodos: Estudio retrospectivo de casos y controles entre el mes de julio de 2014 y junio de 2016. Los casos fueron gestantes que tuvieron muerte fetal intrauterina, y los controles fueron gestantes que tuvieron un recién nacido vivo. Se evaluaron factores como nivel educativo, ocupación, número de controles prenatales (CPN), y la presencia de complicaciones como parto pre-termino, pre-eclampsia o retardo del crecimiento intrauterino (RCIU) Resultados: Se incluyeron 60 casos y 120 controles. El nivel educativo primario (OR: 4,3; IC 95% 1,0-18,0), la ocupación trabajadora (OR: 3,8; IC 95% 1,3-11,0), no tener CPN (OR: 21,0; IC 95% 2,6-170,1), la pre-eclampsia (OR: 4,1; IC 95% 1,3-12,7), el parto pretérmino (OR: 10,1; IC 95% 4.7-21,7) y RCIU (OR: 7,0; IC 95% 2,4-20,5) se asociaron con la mortalidad fetal. Conclusión: Existen factores de riesgo sociodemográficos, obstétricos y patológicos asociados a tener muerte fetal tardía.

https://doi.org/10.15381/anales.803.16855

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