Hospitalization and mortality during the pandemic in chronic hemodialysis patients and the general population in Peru / Hospitalização e mortalidade durante a pandemia em pacientes em hemodiálise crônica e na população em geral no Peru

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.

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.

Características epidemiológicas del recién nacido con peso inferior a 1500 gramos en el Hospital Regional de Ica / Epidemiological characteristics of the newborn weighing less than 1500 grams at Hospital Regional de Ica

Con el objetivo de Identificar las características epidemiológicas de los recién nacidos con menos de 1500 g (RNMBP) ingresados al servicio de neonatología de Hospital Regional de lea, se desarrolló un estudio de tipo retrospectivo, descriptivo y observacional, sobre una población de 1722 recién nacidos, encontrándose una incidencia de 30 RNMBP (1,7%), de los cuales el 73.3% fueron de sexo masculino, la edad gestacional promedio fue de 32 semanas, el peso promedio fue de 1085g, el 93.3% de las madres tuvieron un control prenatal inadecuado, el 3.3 % recibió corticoide prenatal y el 56.6 % fueron productos de la primera gestación, además se encontró una mortalidad de 56.6%, siendo las causas más frecuentes: prematuridad, sepsis neonatal y enfermedad por déficit de surfactante. (AU)

In order to identify the epidemiological characteristics of infants less than 1500 g (V LBW) admitted to the neonatal ward of Hospital Regional de Ica, a retrospective, descriptive, observational developed on a population of 1722 newborns, finding an incidence of 30 VLBW (1.7%), of whom 73.3% were male, the mean gestational age was 32 weeks, the average weight was 1085g, 93.3% of mothers had a control inadequate prenatal, 3.3% received antenatal corticosteroids and 56.6% were products of the first pregnancy, plus 56.6% mortality was found, being the most common causes: prematurity, neonatal sepsis and surfactant deficiency disease. (AU)

The Effect of Cigarette Smoking on Bladder Cancer in Korean: A Prospective Cohort Study / 대한비뇨기과학회지

PURPOSE: To verify the association between cigarette smoking and bladder cancer in the Korean population, as smoking is well known as a risk factor on bladder cancer. The risk of bladder cancer was compared among never-smokers, ex-smokers and current-smokers using a multivariate adjusted incidence rate and the mortality rate of bladder cancer of Koreans. MATERIALS AND METHODS: A total of 348,010 participants were enrolled in this prospective study between 1993 (to 1994) and 2002. All participants completed a self administered questionnaire on cancer risk factors, including smoking habit. Follow up for incident bladder cancer was established. We classified all participants into three categories: current-smoker, ex-smoker and never-smoker, on the basis of their smoking habits. We confirmed bladder cancer from the data of the Korea National Cancer Registry and National Health Insurance Corporation up to (December?) 2002. The multivariate adjusted incidence and the mortality due to bladder cancer were used for both genders for a statistical analysis using a Cox proportional hazards model. RESULTS: The incidence rate of bladder cancer per 100,000 persons in male never-smokers, ex-smokers and current-smokers were 27, 41 and 48, respectively, and the multivariate adjusted relative risks (RR) were 1.3 (95% confidence interval (CI), 0.9-2.0) and 1.7 (95% CI, 1.2-2.3) in ex- and current smokers, respectively. The incidence rate of bladder cancer in women was 4.7, 8.4 and 13, respectively. There was no significant association between the risk of bladder cancer and the amount and duration of smoking. CONCLUSIONS: We concluded that current smokers have an increased incidence and mortality rate of bladder cancer in both genders in the Korean population, but there was no significant difference in relation to the amount and duration of smoking.