Revista Peruana de Medicina de Experimental y Salud Publica最新文献

Objectives.: To determine the perception and experience of obstetric violence during childbirth among postpartum women in a public hospital in Peru.

Materials and methods.: Mixed, descriptive and cross-sectional study during the quantitative phase and with a phenomenological design during the qualitative phase. The population was 444 postpartum women, with a sample made up of 139 postpartum women who had vaginal delivery (surveys) and 21 postpartum women (semi-structured interviews). The study was carried out during the months of April to December 2023.

Results.: We identified that 25.2% of the surveyed women perceived obstetric violence during childbirth and the postpartum period; however, when asked about specific forms of obstetric violence, 100% of postpartum women reported having experienced some form of physical violence and 97.8% responded that they experienced some form of psychological obstetric violence and all the participants reported having suffered at least one form of obstetric violence. Regarding psychological violence, of the total number of puerperal women, 69.1% perceived that they were not informed about consent before signing and undergoing an intervention, 53.2% stated that the staff that assisted them during delivery did not identify themselves by name or profession. With regard to physical obstetric violence, 96.4% did not have a trusted person present during childbirth, 91.4% did not have the option to choose the position in which to give birth (horizontal or vertical), and 76.3% did not have the time for skin-to-skin contact with their newborn. Obstetric violence is expressed in feelings of fear, anguish, anxiety, frustration and loneliness, which puts maternal and neonatal health at risk.

Conclusions.: postpartum women perceive obstetric violence on a psychological level due to the way they are treated by healthcare professionals and on a physical level due to the practices carried out during childbirth, which negatively affect their experiences, causing an emotional impact.

Capillary leak syndrome is a unique complication characterized by extravasation of liquids in the interstitial space due to protein loss caused by snakebite envenoming. We describe the case of a 12-year-old boy from the district of Napo in the city of Iquitos in the Peruvian Amazon, who had edema and increased face volume due to the bite of a snake of the Bothrops genus in the lateral aspect of the right leg; he was the hospitalized and diagnosed with severe ophidism complicated with face edema. The patient received eight vials of antivenin, antibiotics and analgesics. Finally, the patient was discharged from the hospital after eight days of hospitalization, with favorable evolution and recovery.

Motivation for the study. With tuberculosis being the leading cause of death due to infectious diseases in the world, and having a detection gap of 20-40%, there is a need to implement active search strategies for the disease in different vulnerable populations such as juvenile correctional facilities. Main findings. We found a screening rate by active search of 1250 per 100,000 screened, being 10 times more than the rate in the general population. Seventy-five percent of GeneXpert-positive cases were asymptomatic. Implications. By using innovative TB screening mechanisms and algorithms, cases can be identified early, which favors treatment prognosis, as well as reducing the chain of disease transmission. This study aimed to describe the rate of tuberculosis (TB) found by using the active search strategy in teenagers and youths in three youth detention centers. TB was screened through the active search algorithm with chest X-ray, the automated reading was carried out by artificial intelligence software, the GeneXpert Ultra MTB/RIF molecular test, and clinical evaluation. A total of 640 individuals were screened, 94 (14.6%) had an abnormal chest X-ray. Of those screened, we obtained 105 GeneXpert tests of which 94 had abnormal X-rays, 9 were respiratory symptomatic and 2 were on antiretroviral treatment with TB clinical picture. We obtained 8 (8.5%) cases of TB detected with GeneXpert, 7 with abnormal radiography and 1 with normal radiography. Finally, of these 8 cases, 3 were cases of rifampicin-resistant tuberculosis (RR-TB) (42.8%). The rate of screening by active search was 1250 per 100,000 screened, 10 times higher than the rate in the general population. We recommend the inclusion of youth detention centers as target groups for systematic screening and the development of interventions to reduce the risk of TB infection.

Motivation for the study. The frequency of malnutrition in adult patients with grade V chronic kidney disease on hemodialysis at the High Complexity Hospital of La Libertad "Virgen de la Puerta" is unknown. Main findings. We found high frequency of malnutrition in hemodialysis patients (92.4%), with moderate/severe malnutrition predominating (72.4%). Implications. This study allows us to understand the situation of malnutrition in hemodialysis patients in order to initiate early nutritional intervention, in addition to providing important data that add to the available evidence. This was a cross-sectional observational study that aimed to determine the frequency of malnutrition in adult patients with stage V chronic kidney disease on hemodialysis. The sample consisted of 105 adult patients diagnosed stage V chronic kidney disease who received hemodialysis at the "Virgen de la Puerta" High Complexity Hospital in Trujillo, Peru. We applied the Malnutrition-Inflammation Score (MIS), 97 (92.4%) patients presented malnutrition, of which 20% had mild malnutrition, 37.1% had moderate malnutrition and 35.3% had severe malnutrition; only 8 patients (7.6%) presented normal nutritional status. In conclusion, we found a high frequency of malnutrition among patients diagnosed with stage V chronic kidney disease receiving hemodialysis.

Background: Motivation for the study. Apical periodontitis (AP) can trigger immune responses that affect other organs. Main findings. This animal study examined the effects of AP on renal tissue, finding significant changes in parameters such as renal corpuscle area and Bowman's space, which may have implications for chronic kidney disease. Implications. Future research will provide insight into how dental conditions may affect renal health. If confirmed, regular dental checkups would not only be critical to improve the overall health of patients with kidney disease, but could also serve as a preventive measure.

Objectives.: To evaluate the effect of apical periodontitis (AP) induced in Wistar rats on histologically examined renal tissue.

Materials and methods.: Fourteen 12-week-old male Wistar rats weighing an average of 250 grams were used. AP was induced with pulp exposure of the upper and lower first molars using a #1011 HL spherical bur in high rotation. The lesions were left exposed to the oral environment for a period of 7 weeks. Blood pressure was measured by the tail-cuff plethysmography method from the fourth week. The kidney was dissected for histological analysis (H&E). Mann-Whitney and Student's t-test were used for non-parametric and parametric data, respectively, with a significance level of 5%.

Results.: A statistically significant increase in both Bowman's space area and renal corpuscle area was found in the AP group (p<0.05). The AP group had a higher percentage of renal tissue with inflammatory infiltrate, but without significant difference. Blood pressure did change during the experimental period and no difference was identified between the groups.

Conclusions.: Induction of AP in Wistar rats resulted in significant changes of certain renal histological parameters, suggesting a possible interaction between AP and renal tissue that requires further research.

Decision-making in healthcare is complex and needs to be based on the best scientific evidence. In this process, information derived from statistical analysis of data is crucial, which can be developed from either frequentist or Bayesian perspectives. When it comes to the frequentist field, the null hypothesis significance test (NHST) and its p-value is one of the most widely used techniques in different disciplines. However, NHST has been subjected to questioning from different academic points of view, which has led to it being considered as one of the causes of the so-called replicability crisis in science. In this review article, we provide a brief historical account of its development, summarize the underlying methods, describe some controversies and limitations, address misuse and misinterpretation, and finally give some scopes and reflections in the context of biomedical research.

Background: Motivation for the study. The presence of multimorbidity is increasingly frequent in the general population, and this may be associated with mental health problems. Main findings. The presence of multimorbidity, and a great number of chronic conditions, was associated with a higher prevalence of depressive symptoms, anxiety and perceived stress in an adult population in a region of northern Peru. Implications. Our findings suggest the need for adequate mental health management in patients with more than one chronic disease.

Objective.: To evaluate the association between multimorbidity and mental health in adults aged 30 to 69 years.

Materials and methods.: Secondary data analysis of a population-based study conducted in the peri-urban area of Tumbes in the northern coast of Peru. The dependent variables were: depressive symptoms, using the PHQ-9; anxiety symptoms, using the Goldberg scale; and perceived stress, assessed with the Cohen's 14-question scale. The exposure variable was the presence of multimorbidity (presence or not of two or more chronic conditions and the number of chronic conditions). We assessed associations using crude and adjusted Poisson regression models.

Results.: Data from 1600 participants were analyzed, mean age was 48.1 years (SD: 10.5), and 50.4% were women. The prevalence of multimorbidity was 15.9%, 23.3% presented depressive symptoms, 42.0% anxiety symptoms and 31.4% had high levels of perceived stress. The multivariable model showed that multimorbidity was associated with a higher prevalence of depressive symptoms (61%, 95%CI: 32% - 98%), anxiety symptoms (46%, 95%CI: 28% - 66%) and high (22%, 95%CI: 14% - 33%) but not moderate levels of perceived stress (6%; 95%CI: 0% - 12%). A higher number of chronic conditions was associated with higher prevalence of depressive symptoms, anxiety symptoms, and perceived stress levels.

Conclusions.: The presence of multimorbidity is associated with a higher prevalence of depressive symptoms, anxiety symptoms, and perceived stress levels. Our results suggest the need for adequate mental health management in patients with multimorbidity.

Background: Motivation for the study. College students are exposed to numerous stressful events, which predispose them to problems such as depression and anxiety, leading to increased consumption of psychotropic medications. Main findings. The use of psychotropic medications was reported by 12.0% of students, being higher among those with access to health insurance and diagnosed with depression and anxiety, as well as among those who reported using illicit drugs and who were dissatisfied with their academic performance. We found lower consumption of psychotropic drugs among women who consumed alcoholic beverages. Implications. The evidence from this study may support actions to promote not only rational drug use campaigns, but also measures to minimize and help students with the stress of academic life.

Objective.: To analyze the consumption of psychotropic drugs and their associated factors in university students, stratified by sex.

Materials and methods.: We conducted a cross-sectional study with undergraduate students of a public university in Brazil. The instrument was an online self-administered questionnaire. The outcome variable was the use of psychotropic drugs, based on the Anatomical Therapeutic Chemical (ATC) classification system, and the exposure variables were socio-demographic, academic and health-related. The association between the exposure variables and the outcome was verified by calculating prevalence ratios and their 95% confidence intervals.

Results.: We found that 12.2% (n=396) of the 3238 participants used psychotropic drugs; most were women (78.3%). The prevalence of psychotropic drug use was higher among students with access to health insurance, diagnosis of depression and diagnosis of anxiety. It was also higher in the group of women who reported using illicit drugs in the last three months and in the group of men who reported being dissatisfied or very dissatisfied with their academic performance. We detected low frequency of psychotropic drug use among women who consume alcohol on a weekly basis.

Conclusions.: Our results show a higher frequency of psychotropic medication use in females, as well as in students with access to health insurance, diagnosis of depression and diagnosis of anxiety, regardless of sex.

Expanded dengue syndrome are unusual conditions, such as subacute thyroiditis (SAT). We present the case of a 38-year-old woman who had dengue without alarm signs for a month, along with cervical pain and increased cervical volume, palpitations, tremor and dysphagia. Hormonal evaluation, ultrasound and thyroid scintigraphy were consistent with SAT. She received corticoids for two months, with remission after four months. SAT is characterized by neck pain, fever and symptoms of thyrotoxicosis. It is associated with viral infections and it comprises a phase of thyrotoxicosis followed by hypothyroidism. Diagnosis involves hormonal and biochemical tests, thyroid ultrasound with Doppler and scintigraphy. This condition is managed with non-steroidal anti-inflammatory drugs and corticosteroids, according to severity. SAT, an infrequent manifestation of dengue, requires a high degree of suspicion and appropriate management. A review of published cases of SAT due to dengue was carried out in the Scopus, PubMed and Web of Science databases, finding six reported cases, mostly in men.